Provider Demographics
NPI:1780780106
Name:TOTARO, JOSEPH R (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:TOTARO
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:P.O. BOX 849
Mailing Address - Street 2:
Mailing Address - City:TWINBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087
Mailing Address - Country:US
Mailing Address - Phone:216-529-0181
Mailing Address - Fax:216-529-0191
Practice Address - Street 1:1451 WEST 117TH STREET
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44087
Practice Address - Country:US
Practice Address - Phone:216-529-0181
Practice Address - Fax:216-529-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U90687Medicare UPIN