MEDICARE: CANTON CHIROPRACTIC CENTER

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

General Provider Information

NPI Number	:	1356681902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANTON CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	PO BOX 1406
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44648-1406
Country	:	US
Telephone Number	:	330-833-2085
Fax Number	:	330-833-2067

Provider Business Practice Location Address
First Line	:	201 DUEBER AVE SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44706-1164
Country	:	US
Telephone Number	:	330-833-2085
Fax Number	:	330-833-2067

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY VIERHELLER
Credential	:
Telephone Number	:	330-833-2085

Provider Enumeration Date	:	02/19/2013
Last Update Date	:	02/19/2013

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Directions to “CANTON CHIROPRACTIC CENTER ” Practice Location

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