Healthcare Provider Details

I. General information

NPI: 1033249727
Provider Name (Legal Business Name): CARROLLTON CHIROPRACTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 CANTON RD NW
CARROLLTON OH
44615-8426
US

IV. Provider business mailing address

559 CANTON RD NW
CARROLLTON OH
44615-8426
US

V. Phone/Fax

Practice location:
  • Phone: 330-627-7611
  • Fax: 330-627-6773
Mailing address:
  • Phone: 330-627-7611
  • Fax: 330-627-6773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1875
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberOH819
License Number StateOH

VIII. Authorized Official

Name: DR. LOWELL B MYERS II
Title or Position: OWNER
Credential: D.C.
Phone: 330-627-7611