| NPI | 1013011238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALLAN VAN SKYHOCK Member 440-324-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 1467) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 3541) |
| 207Q00000X Family Medicine (Licence: OH 34004082) | |
| 111NR0400X | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2013-01-24 |