Provider Demographics
NPI:1265722185
Name:DR BRIAN C VETTER CHIROPRACTOR PC
Entity type:Organization
Organization Name:DR BRIAN C VETTER CHIROPRACTOR PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:CLANCY
Authorized Official - Last Name:VETTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-427-1602
Mailing Address - Street 1:8137 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-2023
Mailing Address - Country:US
Mailing Address - Phone:440-427-1602
Mailing Address - Fax:440-427-1598
Practice Address - Street 1:8137 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-2023
Practice Address - Country:US
Practice Address - Phone:440-427-1602
Practice Address - Fax:440-427-1598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty