Provider Demographics
NPI:1053681239
Name:LOZINSKI, EDWARD PIOTR (DC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:PIOTR
Last Name:LOZINSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 N. ANKENY BLVD.
Mailing Address - Street 2:SUITE F
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023
Mailing Address - Country:US
Mailing Address - Phone:515-964-7705
Mailing Address - Fax:515-964-7708
Practice Address - Street 1:1517 N ANKENY BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4120
Practice Address - Country:US
Practice Address - Phone:515-964-7705
Practice Address - Fax:515-964-7708
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1518237700Medicaid