Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 731 | OH |
NPI | 1821054784 |
---|---|
Provider Name | Clyde W Esch |
First Address | Huber Heights, OH 45424-2760 |
Second Address | Huber Heights, OH 45424-2760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 04/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4032291 | (02) | OH |
433892 | (05) | OH |
T47043 | (02) | OH |