Provider Demographics
NPI:1811101124
Name:ASHTABULA CHIROPRACTIC CLINIC, INC
Entity type:Organization
Organization Name:ASHTABULA CHIROPRACTIC CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:SAAK
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-998-2200
Mailing Address - Street 1:2709 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-4959
Mailing Address - Country:US
Mailing Address - Phone:440-998-2200
Mailing Address - Fax:440-997-5695
Practice Address - Street 1:2709 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4959
Practice Address - Country:US
Practice Address - Phone:440-998-2200
Practice Address - Fax:440-997-5695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty