Provider Demographics
NPI:1942274071
Name:DERMANELIAN, HARRY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:JOHN
Last Name:DERMANELIAN
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 1:7024 COUNTY ROAD 6 2
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:OH
Mailing Address - Zip Code:43515-9206
Mailing Address - Country:US
Mailing Address - Phone:419-822-9231
Mailing Address - Fax:419-822-9235
Practice Address - Street 1:7024 COUNTY ROAD 6 2
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:OH
Practice Address - Zip Code:43515-9206
Practice Address - Country:US
Practice Address - Phone:419-822-9231
Practice Address - Fax:419-822-9235
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0914176Medicaid
OH000000146922OtherBC/BS
OH02488OtherPARAMOUNT HEALTHCARE
OHDE0733051Medicare ID - Type Unspecified
OH02488OtherPARAMOUNT HEALTHCARE