MEDICARE: DR. KARL D. THEIS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1826	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447243415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARL D. THEIS D.C.

Provider Business Mailing Address
First Line	:	6525 MARKET AVE N
Second Line	:	SUITE 101
City	:	N CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:	330-433-9000
Fax Number	:	330-433-9026

Provider Business Practice Location Address
First Line	:	6525 MARKET AVE N
Second Line	:	SUITE 101
City	:	N CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:	330-433-9000
Fax Number	:	330-433-9026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	10/22/2012

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