Individual
DR. TIMOTHY B VYROSTEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC CCSP
Contact information
Practice address
10633 STATE HIGHWAY 18, CONNEAUT LAKE, PA 16316-3225
(814) 382-1970
(814) 382-3619
Mailing address
10633 STATE HIGHWAY 18, CONNEAUT LAKE, PA 16316-3225
(814) 382-1970
(814) 382-3619
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC007097L
PA
111NS0005X
Sports Physician Chiropractor
Primary
4038
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016549110004
—
PA
01
—
205055
UPMC
PA
01
—
961159
BCBS
PA
Enumeration date
08/17/2006
Last updated
05/03/2023
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