Healthcare Provider Details

I. General information

NPI: 1821054784
Provider Name (Legal Business Name): CLYDE W ESCH DC, FACO, DABFP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 09/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7021 OLD TROY PIKE
HUBER HEIGHTS OH
45424-2760
US

IV. Provider business mailing address

7021 OLD TROY PIKE
HUBER HEIGHTS OH
45424-2760
US

V. Phone/Fax

Practice location:
  • Phone: 937-477-0305
  • Fax: 937-477-0305
Mailing address:
  • Phone: 937-477-0305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number731
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: