| NPI | 1992216915 |
|---|---|
| Doing Business As | HEALTHSOURCE OF FAIRLAWN |
| Entity Type | Organization |
| Authorized Contact | ROBERT EUGENE GRIESSE Owner 330-289-5409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2023-11-15 |