Healthcare Provider Details

I. General information

NPI: 1861893489
Provider Name (Legal Business Name): COMPREHENSIVE HOLISTIC & INTEGRATIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7970 MENTOR AVE SUITE #A3
MENTOR OH
44060-5614
US

IV. Provider business mailing address

7970 MENTOR AVE SUITE #A3
MENTOR OH
44060-5614
US

V. Phone/Fax

Practice location:
  • Phone: 440-781-9237
  • Fax:
Mailing address:
  • Phone: 440-781-9237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4396
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number020826
License Number StateOH

VIII. Authorized Official

Name: DR. CHERIE L GALLANT
Title or Position: OWNER/CEO
Credential: D.C., M.S.
Phone: 440-781-9237