Provider Demographics
NPI:1497853287
Name:AMASH, ROLAND J (DC)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:J
Last Name:AMASH
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 1:6725 STATE ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:OH
Mailing Address - Zip Code:45744-7307
Mailing Address - Country:US
Mailing Address - Phone:740-373-8222
Mailing Address - Fax:740-373-8297
Practice Address - Street 1:6725 STATE ROUTE 60
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:OH
Practice Address - Zip Code:45744-7307
Practice Address - Country:US
Practice Address - Phone:740-373-8222
Practice Address - Fax:740-373-8297
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0919475Medicaid
OH4666465OtherAETNA
OH4900519-004OtherCIGNA
OH000000120475OtherANTHEM
OH000000120475OtherANTHEM