Provider Demographics
NPI:1346370426
Name:QURESHI, OMAR (DC)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:QURESHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24932 AURORA RD STE C
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1790
Mailing Address - Country:US
Mailing Address - Phone:440-439-9440
Mailing Address - Fax:440-439-9447
Practice Address - Street 1:24932 AURORA RD STE C
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1790
Practice Address - Country:US
Practice Address - Phone:440-439-9440
Practice Address - Fax:440-439-9447
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor