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General NPI Number Information
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NPI Number | 1417097296
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Entity Type | Individual
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Provider Name | ANDRE J CAMELLI D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 01/24/2008
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Provider Practice Location Address
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Address Line | 1980 NILES CORTLAND RD NE
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City | CORTLAND
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State | OH
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Zip | 44410-9405
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Country | US
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Telephone | 330-609-0355
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Fax | 330-609-0335
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Provider Business Mailing Address
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Address Line | 1980 NILES CORTLAND RD NE
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City | CORTLAND
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State | OH
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Zip | 44410-9405
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Country | US
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Telephone | 330-609-0355
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Fax | 330-609-0335
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC.3115
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License Number State | OH
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