Provider Demographics
NPI:1093282196
Name:INFIELD CHIROPRACTIC CLINIC LLC
Entity Type:Organization
Organization Name:INFIELD CHIROPRACTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:INFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACBSP
Authorized Official - Phone:216-938-7889
Mailing Address - Street 1:22570 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1315
Mailing Address - Country:US
Mailing Address - Phone:216-938-7889
Mailing Address - Fax:216-965-0872
Practice Address - Street 1:22570 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1315
Practice Address - Country:US
Practice Address - Phone:216-938-7889
Practice Address - Fax:216-965-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty