Provider Demographics
NPI:1194860213
Name:MENTOR CHIROPRACTIC AND REHABILITATION INC
Entity Type:Organization
Organization Name:MENTOR CHIROPRACTIC AND REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:CPC,CPCH,MBP,CMA
Authorized Official - Phone:440-352-6132
Mailing Address - Street 1:7249 CENTER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4907
Mailing Address - Country:US
Mailing Address - Phone:440-205-9910
Mailing Address - Fax:440-974-2400
Practice Address - Street 1:7249 CENTER ST STE 2
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4907
Practice Address - Country:US
Practice Address - Phone:440-205-9910
Practice Address - Fax:440-974-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty