Organization
F O R M E MEDICAL AND REHAB CENTER OF WARREN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NESTOR A STYCHNO D.M., D.C. (PRESIDENT)
(330) 544-3737
Entity
Organization
Contact information
Practice address
2103 NILES CORTLAND RD SE, WARREN, OH 44484-3067
(330) 544-3737
(330) 544-3904
Mailing address
2103 NILES CORTLAND RD SE, WARREN, OH 44484-3067
(330) 544-3737
(330) 544-3904
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
139
OH
111N00000X
Chiropractor
2393
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
35050935
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119473
—
OH
05
—
0608444
—
OH
05
—
2459129
—
OH
Enumeration date
12/11/2006
Last updated
09/29/2011
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