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General NPI Number Information
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NPI Number | 1720272784
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Entity Type | Organization
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Legal Business Name | AULT CHIROPRACTIC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 130 W STREETSBORO ST STE 2
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City | HUDSON
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State | OH
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Zip | 44236-2757
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Country | US
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Telephone | 330-342-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 130 W STREETSBORO ST STE 2
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City | HUDSON
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State | OH
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Zip | 44236-2757
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Country | US
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Telephone | 330-342-0755
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT J AULT
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Credential | D.C.
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Telephone | 330-519-6479
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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 | 3826 AND 3827
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License Number State | OH
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