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General NPI Number Information
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NPI Number | 1104037902
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Entity Type | Organization
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Legal Business Name | CHEATLE CHIROPRACTIC & REHAB CENTER
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2315 LINCOLN WAY E
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City | MASSILLON
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State | OH
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Zip | 44646-7063
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Country | US
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Telephone | 330-833-7007
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Fax | 330-833-7541
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Provider Business Mailing Address
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Address Line | 2315 LINCOLN WAY E
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City | MASSILLON
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State | OH
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Zip | 44646-7063
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Country | US
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Telephone | 330-833-7007
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Fax | 330-833-7541
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON A CHEATLE
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Credential | D.C
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Telephone | 330-833-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 2715
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License Number State | OH
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