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General NPI Number Information
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NPI Number | 1437266459
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Entity Type | Organization
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Legal Business Name | COMPLETE CHIROPRACTIC LIFE CENTER
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5225 CLEVELAND RD SUITE A
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City | WOOSTER
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State | OH
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Zip | 44691
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Country | US
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Telephone | 330-345-3336
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Fax | 330-345-1190
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Provider Business Mailing Address
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Address Line | 5225 CLEVELAND RD SUITE A
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City | WOOSTER
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State | OH
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Zip | 44691
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Country | US
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Telephone | 330-345-3336
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Fax | 330-345-1190
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Authorized Official
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Title or Position | PARTNER
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Name | DALE C CAPELA
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Credential | DC
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Telephone | 330-345-3336
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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 | 242
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2577
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License Number State | OH
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