Provider Demographics
NPI:1275716813
Name:MARK J DEMALIO DC INC
Entity Type:Organization
Organization Name:MARK J DEMALIO DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DEMALIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-652-5600
Mailing Address - Street 1:1250 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4649
Mailing Address - Country:US
Mailing Address - Phone:330-652-5600
Mailing Address - Fax:
Practice Address - Street 1:1250 YOUNGSTOWN WARREN RD
Practice Address - Street 2:SUITE B
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446
Practice Address - Country:US
Practice Address - Phone:330-652-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1902111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000139904OtherANTHEM BCBS
OH0911204Medicaid
OH2303009OtherAETNA
OH=========OtherOHIO BWC
OH=========003OtherMEDICAL MUTUAL OF OHIO
OH=========003OtherMEDICAL MUTUAL OF OHIO
OH0911204Medicaid