Provider Demographics
NPI:1215946967
Name:SALAS, SAMUEL F (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:F
Last Name:SALAS
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 1:2274 KRESGE DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1260
Mailing Address - Country:US
Mailing Address - Phone:440-670-5975
Mailing Address - Fax:440-210-6444
Practice Address - Street 1:2274 KRESGE DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1260
Practice Address - Country:US
Practice Address - Phone:440-670-5975
Practice Address - Fax:440-210-6444
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2105Medicare PIN
OHU27419Medicare UPIN