Provider Demographics
NPI:1235292822
Name:LAKEWOOD PAIN MANAGEMENT & CHIROPRACTIC REHABILITATION LLC
Entity Type:Organization
Organization Name:LAKEWOOD PAIN MANAGEMENT & CHIROPRACTIC REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-289-8660
Mailing Address - Street 1:P.O. BOX 849
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087
Mailing Address - Country:US
Mailing Address - Phone:216-289-8660
Mailing Address - Fax:216-289-8662
Practice Address - Street 1:LAKEWOOD PAIN MANAGEMENT & CHIROPRACTIC LLC
Practice Address - Street 2:1451 WEST 117TH
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107
Practice Address - Country:US
Practice Address - Phone:216-529-0181
Practice Address - Fax:216-289-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty