Provider Demographics
NPI:1447556741
Name:DR CECIL CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DR CECIL CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:E J
Authorized Official - Last Name:CECIL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:234-600-5089
Mailing Address - Street 1:5000 E MARKET ST STE 8
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2259
Mailing Address - Country:US
Mailing Address - Phone:234-600-5089
Mailing Address - Fax:234-600-5101
Practice Address - Street 1:5000 E MARKET ST STE 8
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2259
Practice Address - Country:US
Practice Address - Phone:234-600-5089
Practice Address - Fax:234-600-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty