Provider Demographics
NPI:1699818880
Name:SECOY, ROBERT MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:SECOY
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 1:12573 CHILLICOTHE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2536
Mailing Address - Country:US
Mailing Address - Phone:440-729-0612
Mailing Address - Fax:440-729-0613
Practice Address - Street 1:12573 CHILLICOTHE RD STE 3
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2536
Practice Address - Country:US
Practice Address - Phone:440-729-0612
Practice Address - Fax:440-729-0613
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34181455900OtherWORKERS COMPENSATION
OH341814559001OtherMEDICAL MUTUAL
OH44-00302OtherUNITED HEALTHCARE
OH000000139586OtherANTHEM BLUE CROSS
OH000000139586OtherOHIO OPERATING ENGINEERS
OH000000139586OtherANTHEM BLUE CROSS