Provider Demographics
NPI:1336293034
Name:BRECHBILL, VINCENT JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:JOHN
Last Name:BRECHBILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4336 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2824
Mailing Address - Country:US
Mailing Address - Phone:330-649-2700
Mailing Address - Fax:330-649-2702
Practice Address - Street 1:4336 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2824
Practice Address - Country:US
Practice Address - Phone:330-649-2700
Practice Address - Fax:330-649-2702
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBR4253872Medicare PIN
BR4253872Medicare PIN