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General NPI Number Information
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NPI Number | 1235292822
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Entity Type | Organization
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Legal Business Name | LAKEWOOD PAIN MANAGEMENT & CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | LAKEWOOD PAIN MANAGEMENT & CHIROPRACTIC LLC 1451 WEST 117TH
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City | LAKEWOOD
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State | OH
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Zip | 44107
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Country | US
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Telephone | 216-529-0181
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Fax | 216-289-0191
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Provider Business Mailing Address
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Address Line | P.O. BOX 849
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City | TWINSBURG
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State | OH
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Zip | 44087
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Country | US
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Telephone | 216-289-8660
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Fax | 216-289-8662
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LISA MARIE HARTMAN
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Credential |
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Telephone | 440-477-4863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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