Provider Demographics
NPI:1487796942
Name:TYKS CHIROPRACTIC, INC
Entity type:Organization
Organization Name:TYKS CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:TYKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-474-0877
Mailing Address - Street 1:PO BOX 3009
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-3009
Mailing Address - Country:US
Mailing Address - Phone:207-474-0877
Mailing Address - Fax:207-474-0878
Practice Address - Street 1:220 MADISON AVE
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-3009
Practice Address - Country:US
Practice Address - Phone:207-474-0877
Practice Address - Fax:207-474-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME100042OtherANTHEM
ME4779178OtherCIGNA
ME100042OtherANTHEM