# POWELL CHIROPRACTIC CLINIC INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275608531
- **Authorized official:** AMANDA L DEESER AO (AUTHORIZED OFFICIAL- OFFICE MANAGER)
- **Authorized official phone:** (330) 494-5533

## Contact information

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

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 11/22/2006
- **Last updated:** 07/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0186025 | — | OH |
| 05 | — | 2525628 | — | OH |
| 01 | — | DH0008 | RAILROAD MEDICARE | OH |