| NPI | 1609094770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA L GROVES Billing/Credentialing Manager 440-352-4321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2015-01-27 |