Provider Demographics
NPI:1508841313
Name:RAI, HARISH K (DC)
Entity Type:Individual
Prefix:
First Name:HARISH
Middle Name:K
Last Name:RAI
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 1:11443 STATE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3262
Mailing Address - Country:US
Mailing Address - Phone:330-345-4440
Mailing Address - Fax:
Practice Address - Street 1:242 E MILLTOWN RD
Practice Address - Street 2:CHAFFEE CHIROPRACTIC CLINIC
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1246
Practice Address - Country:US
Practice Address - Phone:330-345-4440
Practice Address - Fax:330-345-9335
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RA057882Medicare ID - Type Unspecified
U78895Medicare UPIN