Provider Demographics
NPI:1083726020
Name:CLEVELAND CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:CLEVELAND CHIROPRACTIC CLINIC, LLC
Other - Org Name:ALAWAN PRO ACTIVE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEB
Authorized Official - Middle Name:HAIDER
Authorized Official - Last Name:ALAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-846-1200
Mailing Address - Street 1:14399 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-8713
Mailing Address - Country:US
Mailing Address - Phone:440-846-1200
Mailing Address - Fax:440-846-1775
Practice Address - Street 1:14399 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-8713
Practice Address - Country:US
Practice Address - Phone:440-846-1200
Practice Address - Fax:440-846-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9363961OtherPTAN