Provider Demographics
NPI:1154407351
Name:CAMPANA, THOMAS MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:CAMPANA
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 1:1006 VALLEY CREK DR
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095
Mailing Address - Country:US
Mailing Address - Phone:440-951-5441
Mailing Address - Fax:
Practice Address - Street 1:25100 EUCLID AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117
Practice Address - Country:US
Practice Address - Phone:216-965-4970
Practice Address - Fax:216-731-6605
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor