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Chiropractic Providers Chiropractor Neurology

Provider NPI: 1306040191

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 614-476-6888  Fax: 614-476-4988

Business Mailing Address:
PO BOX 3717  MANSFIELD, OH 44907-0717 US
Tel: 419-756-1587  Fax: 419-756-2085

NPI Information:
NPI: 1306040191
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y111NN0400XChiropractic Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 111NN0400X





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