Healthcare Provider Details

I. General information

NPI: 1043579345
Provider Name (Legal Business Name): ERIC BRANDON CAWLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2012
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6508 DETROIT AVE
CLEVELAND OH
44102-3014
US

IV. Provider business mailing address

6508 DETROIT AVE
CLEVELAND OH
44102-3014
US

V. Phone/Fax

Practice location:
  • Phone: 216-334-1401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CCP.0029818
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4281
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: