Provider Demographics
NPI:1982728077
Name:FAMILY CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BIZJAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-405-2751
Mailing Address - Street 1:9630 RAVENNA ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087
Mailing Address - Country:US
Mailing Address - Phone:330-405-2751
Mailing Address - Fax:330-405-2752
Practice Address - Street 1:9630 RAVENNA ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087
Practice Address - Country:US
Practice Address - Phone:330-405-2751
Practice Address - Fax:330-405-2752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========-002OtherMEDICAL MUTUAL OF OHIO
OH=========-00OtherBWC
OH=========-002OtherMEDICAL MUTUAL OF OHIO