Provider Demographics
NPI:1518156751
Name:LORAIN CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:LORAIN CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:SCHEITHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-282-7132
Mailing Address - Street 1:5361 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3437
Mailing Address - Country:US
Mailing Address - Phone:440-282-7132
Mailing Address - Fax:440-282-7132
Practice Address - Street 1:5361 OBERLIN AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-3437
Practice Address - Country:US
Practice Address - Phone:440-282-7132
Practice Address - Fax:440-282-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0585719Medicaid
OHT48195Medicare UPIN
OH9262711Medicare PIN