Provider Demographics
NPI:1407991763
Name:CHIRO-CARE NETWORK INC.
Entity Type:Organization
Organization Name:CHIRO-CARE NETWORK INC.
Other - Org Name:ACTIVE SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-453-7800
Mailing Address - Street 1:2716 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3310
Mailing Address - Country:US
Mailing Address - Phone:330-453-7800
Mailing Address - Fax:330-454-8399
Practice Address - Street 1:2716 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3310
Practice Address - Country:US
Practice Address - Phone:330-453-7800
Practice Address - Fax:330-454-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2779111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2093041Medicaid
OH2093041Medicaid
OHU73201Medicare UPIN