MEDICARE: GENTNER CHIROPRACTIC & WELLNESS LLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1730602871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTNER CHIROPRACTIC & WELLNESS LLC

Provider Business Mailing Address
First Line	:	13708 MADISON AVE
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4711
Country	:	US
Telephone Number	:	216-221-2008
Fax Number	:	216-221-6446

Provider Business Practice Location Address
First Line	:	13708 MADISON AVE
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4711
Country	:	US
Telephone Number	:	216-221-2008
Fax Number	:	216-221-6446

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN F GENTNER
Credential	:	DC
Telephone Number	:	216-221-2008

Provider Enumeration Date	:	07/20/2017
Last Update Date	:	07/21/2022

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