Provider Demographics
NPI:1356681902
Name:CANTON CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:CANTON CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:VIERHELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-833-2085
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44648-1406
Mailing Address - Country:US
Mailing Address - Phone:330-833-2085
Mailing Address - Fax:330-833-2067
Practice Address - Street 1:201 DUEBER AVE SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-1164
Practice Address - Country:US
Practice Address - Phone:330-833-2085
Practice Address - Fax:330-833-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty