Healthcare Provider Details

I. General information

NPI: 1487834412
Provider Name (Legal Business Name): TRUMBULL COUNTY CHIROPRACTIC CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 NILES CORTLAND RD NE
WARREN OH
44484-1938
US

IV. Provider business mailing address

260 NILES CORTLAND RD NE
WARREN OH
44484-1938
US

V. Phone/Fax

Practice location:
  • Phone: 330-372-9000
  • Fax: 330-856-3942
Mailing address:
  • Phone: 330-372-9000
  • Fax: 330-856-3942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. PATRICK A ENSMINGER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 330-372-9000