MEDICARE: DR. EFSTATHIOS (STATHIS) D. PALASKAS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	925	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000134226	OTHER	OH	ANTHEM PROVIDER NUMBER
2	341569556-00	OTHER	OH	WORKER'S COMP PROVIDER

General Provider Information

NPI Number	:	1174520340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EFSTATHIOS (STATHIS) D. PALASKAS D.C.

Provider Business Mailing Address
First Line	:	4235 DOUGLAS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3867
Country	:	US
Telephone Number	:	419-474-7600
Fax Number	:	419-474-7054

Provider Business Practice Location Address
First Line	:	4235 DOUGLAS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3867
Country	:	US
Telephone Number	:	419-474-7600
Fax Number	:	419-474-7054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2005
Last Update Date	:	07/09/2007

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