Healthcare Provider Details

I. General information

NPI: 1578920971
Provider Name (Legal Business Name): BUE CHIROPRACTIC LLC, DBA THE CHIROPRACTIC WELLNESS CENTER OF HUDSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 01/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 DARROW RD
HUDSON OH
44236-4003
US

IV. Provider business mailing address

5111 DARROW RD
HUDSON OH
44236-4003
US

V. Phone/Fax

Practice location:
  • Phone: 330-656-1977
  • Fax:
Mailing address:
  • Phone: 330-656-1977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4303
License Number StateNY

VIII. Authorized Official

Name: SHARON L ARNOLD
Title or Position: OFFICE MANAGER
Credential:
Phone: 330-656-1977