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NPI Code Detail

MEDICARE: MICHAEL DIAMOND DC

MEDICARE:   MICHAEL  DIAMOND  DC
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
1111N00000XChiropractor4498OH

General Provider Information

NPI Number : 1689062499
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL DIAMOND DC
Provider Business Mailing Address
First Line : 7257 CENTER ST
Second Line :
City : MENTOR
State : OH
Zip : 44060-4907
Country : US
Telephone Number : 440-205-9910
Fax Number : 440-974-2400
Provider Business Practice Location Address
First Line : 7257 CENTER ST
Second Line :
City : MENTOR
State : OH
Zip : 44060-4907
Country : US
Telephone Number : 440-205-9910
Fax Number : 440-974-2400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2014
Last Update Date : 12/31/2014

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Directions to “ MICHAEL DIAMOND DC” Practice Location

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