Provider Demographics
NPI:1881649788
Name:GOLSCH, ROY A (DC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:A
Last Name:GOLSCH
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 1:15350 BAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4824
Mailing Address - Country:US
Mailing Address - Phone:440-886-4990
Mailing Address - Fax:440-886-1288
Practice Address - Street 1:15350 BAGLEY RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-4824
Practice Address - Country:US
Practice Address - Phone:440-866-4990
Practice Address - Fax:440-866-1288
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0610360Medicaid
OH350047457OtherMEDICARE RAILROAD PIN
OH0610360Medicaid
OHT48272Medicare UPIN