Healthcare Provider Details

I. General information

NPI: 1932300704
Provider Name (Legal Business Name): ELIA ACUNA DC LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E. INDIANA AVE.
MAUMEE OH
43537-0628
US

IV. Provider business mailing address

111 E INDIANA AVE
MAUMEE OH
43537-2825
US

V. Phone/Fax

Practice location:
  • Phone: 419-740-3099
  • Fax: 419-740-3095
Mailing address:
  • Phone: 419-740-3099
  • Fax: 419-740-3095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIA ACUNA-TINDALL
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 419-740-3099