Provider Demographics
NPI:1477951804
Name:UNIVERSITY CHIROPRACTIC AND WELLNESS
Entity Type:Organization
Organization Name:UNIVERSITY CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-605-9884
Mailing Address - Street 1:2108 STATE ROUTE 59
Mailing Address - Street 2:UNIT A
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-7142
Mailing Address - Country:US
Mailing Address - Phone:330-678-9999
Mailing Address - Fax:
Practice Address - Street 1:2108 STATE ROUTE 59
Practice Address - Street 2:UNIT A
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-7142
Practice Address - Country:US
Practice Address - Phone:330-678-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty