Provider Demographics
NPI:1811945207
Name:HRYCKO, MICHAEL A (DC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:HRYCKO
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 1:115 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-2001
Mailing Address - Country:US
Mailing Address - Phone:724-547-0821
Mailing Address - Fax:
Practice Address - Street 1:115 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-2001
Practice Address - Country:US
Practice Address - Phone:724-542-8001
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004804L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001441707Medicaid
PA001441707Medicaid
U21669Medicare UPIN