Provider Demographics
NPI:1013509249
Name:ABOOD, MICHAEL N (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:N
Last Name:ABOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38191 STRUMBLY PL
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-6591
Mailing Address - Country:US
Mailing Address - Phone:440-488-0589
Mailing Address - Fax:
Practice Address - Street 1:9630 RAVENNA RD STE 100
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6812
Practice Address - Country:US
Practice Address - Phone:330-405-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05063111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor