Provider Demographics
NPI:1962420562
Name:VECHIARELLI, DOMINIC BERT (DC)
Entity type:Individual
Prefix:
First Name:DOMINIC
Middle Name:BERT
Last Name:VECHIARELLI
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 1:853 WESTPOINT PKWY
Mailing Address - Street 2:STE 730
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1532
Mailing Address - Country:US
Mailing Address - Phone:440-250-9072
Mailing Address - Fax:440-250-9105
Practice Address - Street 1:853 WESTPOINT PKWY
Practice Address - Street 2:SUITE 750
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1532
Practice Address - Country:US
Practice Address - Phone:440-250-9072
Practice Address - Fax:440-250-9105
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2298213Medicaid
OHU88438Medicare UPIN
OH4066251Medicare ID - Type Unspecified