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General NPI Number Information
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NPI Number | 1427243757
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Entity Type | Organization
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Legal Business Name | CUYAHOGA CHIROPRACTIC INC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 11/11/2011
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Provider Practice Location Address
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Address Line | 14100 CEDAR RD SUITE 100
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City | CLEVELAND
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State | OH
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Zip | 44121-3212
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Country | US
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Telephone | 216-297-9779
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Fax | 216-297-9810
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Provider Business Mailing Address
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Address Line | 14100 CEDAR RD SUITE 100
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City | CLEVELAND
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State | OH
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Zip | 44121-3212
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Country | US
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Telephone | 216-297-9779
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Fax | 216-297-9810
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JESSICA U SHELLEY
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Credential | DC
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Telephone | 216-297-9779
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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 | 3105
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License Number State | OH
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