Provider Demographics
NPI:1437300316
Name:VASCURA, DAVID J (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:VASCURA
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 1:2110 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2025
Mailing Address - Country:US
Mailing Address - Phone:740-455-5555
Mailing Address - Fax:740-455-4648
Practice Address - Street 1:2110 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2025
Practice Address - Country:US
Practice Address - Phone:740-455-5555
Practice Address - Fax:740-455-4648
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311174655-01OtherW/C
OH2102978Medicaid
OHVA087380Medicare PIN
OH2102978Medicaid