Provider Demographics
NPI:1407976863
Name:CHIROPRACTIC CENTER OF SOLON, INC.
Entity Type:Organization
Organization Name:CHIROPRACTIC CENTER OF SOLON, INC.
Other - Org Name:CHIROPRACTIC CLINIC OF SOLON, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:RADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-248-8888
Mailing Address - Street 1:33141 BAINBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2835
Mailing Address - Country:US
Mailing Address - Phone:440-248-8888
Mailing Address - Fax:440-349-4026
Practice Address - Street 1:33141 BAINBRIDGE RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2835
Practice Address - Country:US
Practice Address - Phone:440-248-8888
Practice Address - Fax:440-349-4026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000164594OtherANTHEM BLUE CROSS
OHCN3528OtherRAILROAD MEDICARE
OH=========-00OtherOHIO BUREAU OF WORKER'S C
OH=========-003OtherMEDICAL MUTUAL OF OHIO
OHCH9305921Medicare ID - Type Unspecified