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Organization

POWELL CHIROPRACTIC CLINIC INC

Active
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Organization

POWELL CHIROPRACTIC CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA L DEESER AO (AUTHORIZED OFFICIAL- OFFICE MANAGER)
(330) 494-5533
Entity
Organization

Contact information

Practice address
4867 MUNSON ST NW, CANTON, OH 44718
(330) 494-5533
(330) 494-8101
Mailing address
4867 MUNSON ST NW, CANTON, OH 44718
(330) 494-5533
(330) 494-8101

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186025
—
OH
05
—
2525628
—
OH
01
—
DH0008
RAILROAD MEDICARE
OH
Enumeration date
11/22/2006
Last updated
07/09/2024
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