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General NPI Number Information
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NPI Number | 1417139064
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Entity Type | Organization
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Legal Business Name | KAMMS CORNERS CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 12/05/2007
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 16806 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5509
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Country | US
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Telephone | 216-251-9585
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Fax | 216-251-9064
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Provider Business Mailing Address
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Address Line | 16806 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5509
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Country | US
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Telephone | 216-251-9585
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Fax | 216-251-9064
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. JON EDWARD WRONKO
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Credential | D.C.
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Telephone | 216-251-9585
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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 | OH2616
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License Number State | OH
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