Healthcare Provider Details

I. General information

NPI: 1700802667
Provider Name (Legal Business Name): MICHAEL ANTHONY JAMES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 AVONDALE LN NW
CANTON OH
44708-1670
US

IV. Provider business mailing address

4310 AVONDALE LN NW
CANTON OH
44708-1670
US

V. Phone/Fax

Practice location:
  • Phone: 330-479-9345
  • Fax: 888-892-8335
Mailing address:
  • Phone: 330-479-9345
  • Fax: 888-892-8335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number3517
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: