Provider Demographics
NPI:1851302681
Name:TOCCO, SALVATOR J (DC)
Entity Type:Individual
Prefix:DR
First Name:SALVATOR
Middle Name:J
Last Name:TOCCO
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 1:30972 WALDEN DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-6815
Mailing Address - Country:US
Mailing Address - Phone:440-899-7988
Mailing Address - Fax:
Practice Address - Street 1:4859 DOVER CENTER RD
Practice Address - Street 2:SUITE 13
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3184
Practice Address - Country:US
Practice Address - Phone:440-777-0855
Practice Address - Fax:440-779-7040
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2002826Medicaid
OH2002826Medicaid
OHTO071212Medicare ID - Type Unspecified