Provider Demographics
NPI:1710523311
Name:AIR I
Entity Type:Organization
Organization Name:AIR I
Other - Org Name:ACCIDENT INJURY CENTER OF AKRON LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FABER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-835-9918
Mailing Address - Street 1:PO BOX 20770
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0770
Mailing Address - Country:US
Mailing Address - Phone:330-835-9918
Mailing Address - Fax:330-983-9872
Practice Address - Street 1:2086 ROMIG RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3820
Practice Address - Country:US
Practice Address - Phone:330-835-9918
Practice Address - Fax:330-983-9872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0362743Medicaid