Healthcare Provider Details

I. General information

NPI: 1376789818
Provider Name (Legal Business Name): HARRY C WALKER DC DM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 MENTOR AVE
PAINESVILLE OH
44077-3105
US

IV. Provider business mailing address

263 MENTOR AVE
PAINESVILLE OH
44077-3105
US

V. Phone/Fax

Practice location:
  • Phone: 440-354-5643
  • Fax: 440-354-5645
Mailing address:
  • Phone: 440-354-5643
  • Fax: 440-354-5645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL CARDINALE
Title or Position: OFFICE MANAGER
Credential:
Phone: 440-354-5643