Provider Demographics
NPI:1922750702
Name:BISSON, ONDREA
Entity Type:Individual
Prefix:
First Name:ONDREA
Middle Name:
Last Name:BISSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 BIRDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6205
Mailing Address - Country:US
Mailing Address - Phone:330-328-2859
Mailing Address - Fax:
Practice Address - Street 1:3637 MEDINA RD STE 85
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8153
Practice Address - Country:US
Practice Address - Phone:330-952-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor