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General NPI Number Information
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NPI Number | 1083799654
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Entity Type | Organization
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Legal Business Name | BUCKEYE CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 37131 EUCLID AVE
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City | WILLOUGHBY
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State | OH
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Zip | 44094-5611
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Country | US
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Telephone | 440-951-7246
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Fax | 440-946-3066
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Provider Business Mailing Address
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Address Line | 37131 EUCLID AVE
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City | WILLOUGHBY
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State | OH
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Zip | 44094-5611
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Country | US
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Telephone | 440-951-7246
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Fax | 440-946-3066
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER JAMES STANKUS
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Credential | D.C.
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Telephone | 440-951-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3454
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License Number State | OH
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