MEDICARE: MIDDLEBURG HEIGHTS CHIROPRACTIC OFFICE, INC.

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	1139	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558408955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDDLEBURG HEIGHTS CHIROPRACTIC OFFICE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 40450
Second Line	:
City	:	BAY VILLAGE
State	:	OH
Zip	:	44140-0450
Country	:	US
Telephone Number	:	440-871-4700
Fax Number	:	440-871-4702

Provider Business Practice Location Address
First Line	:	15350 BAGLEY RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-4824
Country	:	US
Telephone Number	:	440-866-4990
Fax Number	:	440-866-1288

Authorized Official
Title or Position	:	D.C.
Name	:	DR. ROY A GOLSCH
Credential	:	D.C.
Telephone Number	:	440-886-4990

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	06/02/2016

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