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General NPI Number Information
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NPI Number | 1720314719
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Entity Type | Organization
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Legal Business Name | PERRY CHIROPRACTIC & THERAPY CENTER OF CANTON
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 4933 TUSCARAWAS ST W
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City | CANTON
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State | OH
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Zip | 44708-5011
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Country | US
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Telephone | 330-477-0264
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Fax | 330-477-3037
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Provider Business Mailing Address
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Address Line | 4933 TUSCARAWAS ST W
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City | CANTON
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State | OH
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Zip | 44708-5011
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Country | US
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Telephone | 330-477-3036
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Fax | 330-477-3037
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES THEUS YANG
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Credential | D.C.
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Telephone | 330-477-3036
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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 | OH
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