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General NPI Number Information
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NPI Number | 1871650390
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 3008 STATE ROUTE 5 SUITE B/C
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City | CORTLAND
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State | OH
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Zip | 44410-9203
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Country | US
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Telephone | 330-399-3046
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Fax | 330-282-4306
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Provider Business Mailing Address
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Address Line | 2996 STATE ROUTE 5 SUITE B
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City | CORTLAND
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State | OH
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Zip | 44410-9203
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Country | US
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Telephone | 330-399-3046
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Fax | 330-282-4306
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MRS. ERICA SUE MATTHEWS
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Credential | DC
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Telephone | 330-719-6940
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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 | 602
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License Number State | OH
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