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General NPI Number Information
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NPI Number | 1154541167
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Entity Type | Organization
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Legal Business Name | GEAUGA HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8389 MAYFIELD RD
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City | CHESTERLAND
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State | OH
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Zip | 44026-2565
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Country | US
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Telephone | 440-729-0612
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Fax |
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Provider Business Mailing Address
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Address Line | 8389 MAYFIELD RD
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City | CHESTERLAND
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State | OH
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Zip | 44026-2565
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Country | US
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Telephone | 440-729-0612
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT MICHAEL SECOY
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Credential | D.C.
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Telephone | 440-729-0612
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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 | 1100
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License Number State | OH
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