Provider Demographics
NPI:1467693721
Name:URBAN, MICHAEL JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:URBAN
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 1:20102 CENTER RIDGE RD LOWR
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3533
Mailing Address - Country:US
Mailing Address - Phone:440-895-9595
Mailing Address - Fax:440-895-9596
Practice Address - Street 1:20102 CENTER RIDGE RD LOWR
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3533
Practice Address - Country:US
Practice Address - Phone:440-895-9595
Practice Address - Fax:440-895-9596
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor