# AMBROSE S PERDUK JR DC INC

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

## Provider details

- **NPI number:** 1912112418
- **Authorized official:** DR. AMBROSE S PERDUK JR. DC (PRESIDENT)
- **Authorized official phone:** (330) 343-2621

## Contact information

- **Practice address:** 125 W 2ND STREET, DOVER, OH 44622-2931
- **Practice address phone:** (330) 343-2621
- **Practice address fax:** (330) 343-6006
- **Mailing address:** 125 W 2ND ST, DOVER, OH 44622-2931
- **Mailing address phone:** (330) 343-2621
- **Mailing address fax:** (330) 343-6006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 1155 | OH | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 06/17/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0707668 | — | OH |