Provider Demographics
NPI:1063514230
Name:MCMICHAEL, RICK A (DC)
Entity type:Individual
Prefix:DR
First Name:RICK
Middle Name:A
Last Name:MCMICHAEL
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 1:3945 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718
Mailing Address - Country:US
Mailing Address - Phone:330-492-1010
Mailing Address - Fax:330-492-7506
Practice Address - Street 1:3945 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718
Practice Address - Country:US
Practice Address - Phone:330-492-1010
Practice Address - Fax:330-492-7506
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0276795Medicaid
OHMC0417151Medicare ID - Type Unspecified
OH0276795Medicaid