Organization
POLAND CHIROPRACTIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A DIVITO D,C. (OWNER)
(330) 757-4029
Entity
Organization
Contact information
Practice address
44 N MAIN ST, POLAND, OH 44514-1627
(330) 757-4029
(330) 757-9192
Mailing address
44 N MAIN ST, POLAND, OH 44514-1627
(330) 757-4029
(330) 757-9192
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1354
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0731051
—
OH
Enumeration date
03/18/2011
Last updated
04/01/2011
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