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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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