Provider Demographics
NPI:1023420304
Name:CLEVELAND CHIROPRACTIC AND INTEGRATIVE HEALTH CENTER, LLC
Entity type:Organization
Organization Name:CLEVELAND CHIROPRACTIC AND INTEGRATIVE HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GESICKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:216-952-3830
Mailing Address - Street 1:6909 ROYALTON RD STE 302
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-2478
Mailing Address - Country:US
Mailing Address - Phone:216-952-3830
Mailing Address - Fax:216-373-4969
Practice Address - Street 1:6909 ROYALTON RD STE 302
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-2478
Practice Address - Country:US
Practice Address - Phone:216-952-3830
Practice Address - Fax:216-373-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4441261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty