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General NPI Number Information
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NPI Number | 1467990168
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Entity Type | Organization
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Legal Business Name | INDEPENDENCE ACCIDENT AND INJURY CENTER, LLC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 6701 ROCKSIDE RD SUITE 230
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2358
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Country | US
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Telephone | 216-264-4327
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Fax | 844-737-0784
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Provider Business Mailing Address
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Address Line | 3699 GARDEN CT
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City | GROVE CITY
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State | OH
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Zip | 43123-2906
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Country | US
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Telephone | 216-264-4327
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Fax | 844-737-0784
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Authorized Official
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Title or Position | MEMBER
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Name | ROY KORTH
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Credential |
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Telephone | 216-264-4327
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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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