Provider Demographics
NPI:1376789818
Name:HARRY C WALKER DC DM INC
Entity Type:Organization
Organization Name:HARRY C WALKER DC DM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDINALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-354-5643
Mailing Address - Street 1:263 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3105
Mailing Address - Country:US
Mailing Address - Phone:440-354-5643
Mailing Address - Fax:440-354-5645
Practice Address - Street 1:263 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3105
Practice Address - Country:US
Practice Address - Phone:440-354-5643
Practice Address - Fax:440-354-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center