Provider Demographics
NPI:1851903785
Name:ROCKSIDE NECK BACK & MIGRAINE CENTER LLC
Entity Type:Organization
Organization Name:ROCKSIDE NECK BACK & MIGRAINE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:JARMUSZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-400-2583
Mailing Address - Street 1:6500 ROCKSIDE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2319
Mailing Address - Country:US
Mailing Address - Phone:216-447-9704
Mailing Address - Fax:
Practice Address - Street 1:6500 ROCKSIDE RD STE 160
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2319
Practice Address - Country:US
Practice Address - Phone:216-447-9704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty