Provider Demographics
NPI:1689978835
Name:DAVID P. ESARCO, D.C., LTD.
Entity Type:Organization
Organization Name:DAVID P. ESARCO, D.C., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ESARCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-726-7770
Mailing Address - Street 1:7505 CALIFORNIA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5618
Mailing Address - Country:US
Mailing Address - Phone:330-726-7770
Mailing Address - Fax:330-726-7772
Practice Address - Street 1:7505 CALIFORNIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5618
Practice Address - Country:US
Practice Address - Phone:330-726-7770
Practice Address - Fax:330-726-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0652208Medicaid
OH0652208Medicaid
OHES0608331Medicare UPIN