Healthcare Provider Details

I. General information

NPI: 1841365004
Provider Name (Legal Business Name): JOCDOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6310 MARKET AVE
CANTON OH
44721-4472
US

IV. Provider business mailing address

6310 MARKET AVE
CANTON OH
44721
US

V. Phone/Fax

Practice location:
  • Phone: 330-768-7737
  • Fax: 330-494-8195
Mailing address:
  • Phone: 330-768-7737
  • Fax: 330-494-8195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2063
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1232
License Number StateOH

VIII. Authorized Official

Name: DENISE MAYLE
Title or Position: OFFICE MANAGER
Credential:
Phone: 330-768-7737