Healthcare Provider Details

I. General information

NPI: 1457480261
Provider Name (Legal Business Name): ELYRIA CHIROPRATIC AND REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 MARKET DR
ELYRIA OH
44035-2886
US

IV. Provider business mailing address

230 MARKET DR
ELYRIA OH
44035-2886
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-9000
  • Fax: 440-324-2849
Mailing address:
  • Phone: 440-324-9000
  • Fax: 440-324-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: LINDA L GROVES
Title or Position: BILLING MANAGER
Credential: CPC CPCH
Phone: 440-352-6132