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General NPI Number Information
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NPI Number | 1447468962
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Entity Type | Organization
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Legal Business Name | ACHIEVE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 14524 DETROIT AVE
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City | LAKEWOOD
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State | OH
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Zip | 44107-4317
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Country | US
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Telephone | 216-521-7777
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Fax | 216-521-7778
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Provider Business Mailing Address
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Address Line | 14524 DETROIT AVE.
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City | LAKEWOOD
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State | OH
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Zip | 44107-4317
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Country | US
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Telephone | 216-521-7777
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Fax | 216-521-7778
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL R. IZQUIERDO
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Credential | DC
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Telephone | 216-521-7777
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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 | 3664
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License Number State | OH
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