Provider Demographics
NPI:1649333238
Name:ADVANCED PAIN MANAGEMENT & CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ADVANCED PAIN MANAGEMENT & CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:216-289-2500
Mailing Address - Street 1:5195 MAYFIELD RD # 10
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2464
Mailing Address - Country:US
Mailing Address - Phone:440-477-4863
Mailing Address - Fax:
Practice Address - Street 1:5195 MAYFIELD RD # 10
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2464
Practice Address - Country:US
Practice Address - Phone:440-390-2900
Practice Address - Fax:440-390-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty