Healthcare Provider Details

I. General information

NPI: 1699810887
Provider Name (Legal Business Name): MCCORMACK FAMILY CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7819 BROADVIEW RD
SEVEN HILLS OH
44131-6146
US

IV. Provider business mailing address

7819 BROADVIEW RD
SEVEN HILLS OH
44131-6146
US

V. Phone/Fax

Practice location:
  • Phone: 216-524-7313
  • Fax: 216-524-7312
Mailing address:
  • Phone: 216-524-7313
  • Fax: 216-524-7312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1580
License Number StateOH

VIII. Authorized Official

Name: DR. MARYJO MCCORMACK
Title or Position: OWNER
Credential: DC
Phone: 216-524-7313