Healthcare Provider Details

I. General information

NPI: 1255450573
Provider Name (Legal Business Name): EUCLID CHIROPRACTIC AND THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25941 EUCLID AVE
EUCLID OH
44132-2723
US

IV. Provider business mailing address

25941 EUCLID AVE
EUCLID OH
44132-2723
US

V. Phone/Fax

Practice location:
  • Phone: 216-261-2055
  • Fax: 216-261-2050
Mailing address:
  • Phone: 216-261-2055
  • Fax: 216-261-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY MOORE
Title or Position: MANAGER
Credential: DC
Phone: 216-261-2055