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General NPI Number Information
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NPI Number | 1346487170
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Entity Type | Organization
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Legal Business Name | JEFFERSON PARK SPINE SPECIALISTS, LLC
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 748 GRAHAM RD
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44221-1042
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Country | US
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Telephone | 330-920-1681
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Fax | 330-920-1669
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Provider Business Mailing Address
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Address Line | 748 GRAHAM RD
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44221-1042
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Country | US
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Telephone | 330-920-1681
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Fax | 330-920-1669
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | DR. RYAN PATRICK MEEHAN
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Credential | DC
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Telephone | 330-920-1681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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