Individual
DR. JASON T MARUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
755 BOARDMAN CANFIELD RD, SOUTHBRIDGE WEST, BUILDING P UNIT 1, BOARDMAN, OH 44512-4300
(330) 286-3669
Mailing address
755 BOARDMAN CANFIELD RD, SOUTHBRIDGE WEST, BUILDING P UNIT 1, BOARDMAN, OH 44512-4300
(330) 286-3669
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7589
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2794132
—
OH
05
—
381768700
—
FL
01
—
9375191
MEDICARE
OH
Enumeration date
11/02/2005
Last updated
06/08/2016
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