Provider Demographics
NPI:1104998012
Name:CRISCI, ANTONIO (DC)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:CRISCI
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 1:1081B STATE ROUTE 28 STE 201
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-2001
Mailing Address - Country:US
Mailing Address - Phone:513-576-6699
Mailing Address - Fax:513-576-6452
Practice Address - Street 1:5870 COOK RD UNIT B
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1583
Practice Address - Country:US
Practice Address - Phone:513-576-6699
Practice Address - Fax:513-576-6452
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000020900OtherANTHEM BCBS
OH2007358Medicaid
OHCR0821221Medicare ID - Type Unspecified
OH2007358Medicaid