Provider Demographics
NPI:1891139275
Name:CHIROPRACTIC & REHABILITATION FOR INJURIES AND WELLNESS
Entity Type:Organization
Organization Name:CHIROPRACTIC & REHABILITATION FOR INJURIES AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENAE
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:216-571-0774
Mailing Address - Street 1:5195 MAYFIELD RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2464
Mailing Address - Country:US
Mailing Address - Phone:440-720-1810
Mailing Address - Fax:440-720-1814
Practice Address - Street 1:5195 MAYFIELD RD
Practice Address - Street 2:SUITE 10
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2464
Practice Address - Country:US
Practice Address - Phone:440-720-1810
Practice Address - Fax:440-720-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty