Provider Demographics
NPI:1639516073
Name:ALTMAN CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ALTMAN CHIROPRACTIC, LLC
Other - Org Name:DR. MICHAEL ALTMAN
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-783-0022
Mailing Address - Street 1:3250 W MARKET ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3336
Mailing Address - Country:US
Mailing Address - Phone:330-867-2025
Mailing Address - Fax:
Practice Address - Street 1:3250 W MARKET ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3336
Practice Address - Country:US
Practice Address - Phone:330-867-2025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty