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NPI Code Detail

MEDICARE: SHAKER HEIGHTS SPINAL AND REHABILITATION

MEDICARE: SHAKER HEIGHTS SPINAL AND REHABILITATION
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
1111NR0400XRehabilitation Chiropractor3343OH

General Provider Information

NPI Number : 1932412723
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHAKER HEIGHTS SPINAL AND REHABILITATION
Provider Business Mailing Address
First Line : 3535 LEE RD
Second Line :
City : SHAKER HEIGHTS
State : OH
Zip : 44120-5122
Country : US
Telephone Number : 216-921-6332
Fax Number : 440-937-2239
Provider Business Practice Location Address
First Line : 3535 LEE RD
Second Line :
City : SHAKER HEIGHTS
State : OH
Zip : 44120-5122
Country : US
Telephone Number : 216-921-6332
Fax Number : 440-937-2239
Authorized Official
Title or Position : OWNER
Name : DR. JOHN ROMAN FORTUNA
Credential : D.C.
Telephone Number : 216-321-6332
Provider Enumeration Date : 07/21/2010
Last Update Date : 07/21/2010

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Directions to “SHAKER HEIGHTS SPINAL AND REHABILITATION ” Practice Location

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