Provider Demographics
NPI:1437381324
Name:ARMIN, DERECK (DC)
Entity Type:Individual
Prefix:DR
First Name:DERECK
Middle Name:
Last Name:ARMIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:NANGYALI
Other - Middle Name:
Other - Last Name:AMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:690 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3642
Mailing Address - Country:US
Mailing Address - Phone:440-232-4325
Mailing Address - Fax:440-232-8691
Practice Address - Street 1:690 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-3642
Practice Address - Country:US
Practice Address - Phone:440-232-4325
Practice Address - Fax:440-232-8691
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$00OtherBUREAU OF WORKER'S COMPENSATION