Organization Name: | VAN AKEN HEALTH CENTER, INC. |
NPI Number: | 1114133857 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAYMOND MICHAEL BROCCOLI (OWNER) |
Mailing Address: | 20119 Van Aken Blvd Suite 205 Shaker Heights |
State: | OH US |
Postal Code: | 441223636 |
Phone Number: | 2165611994 |
Fax Number: | 2165610553 |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 2432 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |