Provider Demographics
NPI:1225381718
Name:BEDFORD CHIROPRACTIC & REHABILITATION
Entity Type:Organization
Organization Name:BEDFORD CHIROPRACTIC & REHABILITATION
Other - Org Name:CLEVELAND SPINE & INJURY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DERECK
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-232-4325
Mailing Address - Street 1:690 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3642
Mailing Address - Country:US
Mailing Address - Phone:440-232-4325
Mailing Address - Fax:440-232-8691
Practice Address - Street 1:690 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-3642
Practice Address - Country:US
Practice Address - Phone:440-232-4325
Practice Address - Fax:440-232-8691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-21
Last Update Date:2012-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty