Provider Demographics
NPI:1447390109
Name:FORME MEDICAL & REHAB. CENTER OF FINDLAY, INC
Entity Type:Organization
Organization Name:FORME MEDICAL & REHAB. CENTER OF FINDLAY, INC
Other - Org Name:FORME MEDICAL & REHAB AND KIRK CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-425-9798
Mailing Address - Street 1:116 W LIMA ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3032
Mailing Address - Country:US
Mailing Address - Phone:419-425-9798
Mailing Address - Fax:419-425-9698
Practice Address - Street 1:116 W LIMA ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3032
Practice Address - Country:US
Practice Address - Phone:419-425-9798
Practice Address - Fax:419-425-9698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty