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General NPI Number Information
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NPI Number | 1730677485
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Entity Type | Organization
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Legal Business Name | INSPIRED CHIROPRACTIC & WELLNESS INC
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 07/29/2019
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Provider Practice Location Address
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Address Line | 15644 MADISON AVE STE 213
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City | LAKEWOOD
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State | OH
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Zip | 44107-5622
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Country | US
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Telephone | 216-801-4322
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Fax |
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Provider Business Mailing Address
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Address Line | 2026 HALSTEAD AVE
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City | LAKEWOOD
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State | OH
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Zip | 44107-6209
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Country | US
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Telephone | 937-206-9107
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Fax | 330-319-8842
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Authorized Official
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Title or Position | OWNER
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Name | SARA PERRY
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Credential | D.C.
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Telephone | 937-206-9107
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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 | 4698
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License Number State | OH
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