Provider Demographics
NPI:1285617225
Name:GALOUZIS, KONSTANTINOS D (DC)
Entity type:Individual
Prefix:DR
First Name:KONSTANTINOS
Middle Name:D
Last Name:GALOUZIS
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 1:263 W MCKINLEY WAY
Mailing Address - Street 2:UNIT 101
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1688
Mailing Address - Country:US
Mailing Address - Phone:330-707-9127
Mailing Address - Fax:330-707-9129
Practice Address - Street 1:263 W MCKINLEY WAY
Practice Address - Street 2:UNIT 101
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1688
Practice Address - Country:US
Practice Address - Phone:330-707-9127
Practice Address - Fax:330-707-9129
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3125111N00000X
FLCH8327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1051892OtherHEALTH ASSURANCE
OH2465685Medicaid
OH000000343526OtherANTHEM BC & BS
OH2465685Medicaid
OHU96747Medicare UPIN