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General NPI Number Information
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NPI Number | 1356681902
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Entity Type | Organization
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Legal Business Name | CANTON CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 201 DUEBER AVE SW
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City | CANTON
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State | OH
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Zip | 44706-1164
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Country | US
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Telephone | 330-833-2085
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Fax | 330-833-2067
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Provider Business Mailing Address
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Address Line | PO BOX 1406
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City | MASSILLON
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State | OH
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Zip | 44648-1406
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Country | US
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Telephone | 330-833-2085
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Fax | 330-833-2067
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY VIERHELLER
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Credential |
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Telephone | 330-833-2085
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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 |
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License Number State |
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