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NPI Code Detail

MEDICARE: LISA DAWN ISPHORDING DC

MEDICARE: LISA DAWN ISPHORDING DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH8634FL
2111N00000XChiropractor4032OH
3111N00000XChiropractor2301009585MI

General Provider Information

NPI Number : 1558581751
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA DAWN ISPHORDING DC
Provider Business Mailing Address
First Line : 3310 WARREN RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-2031
Country : US
Telephone Number : 216-476-1700
Fax Number :
Provider Business Practice Location Address
First Line : 3310 WARREN RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-2031
Country : US
Telephone Number : 216-476-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2007
Last Update Date : 04/28/2010

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Directions to “ LISA DAWN ISPHORDING DC” Practice Location

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