Provider Demographics
NPI:1235300724
Name:GENEVA SPINAL HEALTH AND PAIN MANAGEMENT L.L.C.
Entity Type:Organization
Organization Name:GENEVA SPINAL HEALTH AND PAIN MANAGEMENT L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTIC PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MARSHAL
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-813-0285
Mailing Address - Street 1:23 S FOREST ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-1620
Mailing Address - Country:US
Mailing Address - Phone:440-466-0860
Mailing Address - Fax:440-466-0710
Practice Address - Street 1:23 S FOREST ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-1620
Practice Address - Country:US
Practice Address - Phone:440-466-0860
Practice Address - Fax:440-466-0710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty