# LIGHTHOUSE CHIROPRACTIC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639495278
- **Authorized official:** RONALD TYSZKOWSKI (PRESIDENT)
- **Authorized official phone:** (401) 490-0494

## Contact information

- **Practice address:** 717 ALLENS AVE, PROVIDENCE, RI 02905-5412
- **Practice address phone:** (401) 751-6568
- **Mailing address:** PO BOX 9117, WARWICK, RI 02889-0117
- **Mailing address phone:** (401) 751-6568

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 346 | RI | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD14078 | RI | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | MD14078 | RI | — |

## Other

- **Enumeration date:** 04/07/2010
- **Last updated:** 11/14/2012