Provider Demographics
NPI:1417017880
Name:RUCH, JAMES EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:RUCH
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 1:100 N MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3704
Mailing Address - Country:US
Mailing Address - Phone:330-864-6800
Mailing Address - Fax:330-864-6940
Practice Address - Street 1:100 N MILLER RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3704
Practice Address - Country:US
Practice Address - Phone:330-864-6800
Practice Address - Fax:330-864-6940
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1762111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0901206Medicaid
OH000000040993OtherANTHEM BCBS
OH31133721600OtherOHIO WORKER'S COMPENSATIO
OH31133721600OtherOHIO WORKER'S COMPENSATIO