MEDICARE: CHAGRIN WARREN CHIROPRACTIC AND REHABILITATION CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3026	OH

General Provider Information

NPI Number	:	1841457702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAGRIN WARREN CHIROPRACTIC AND REHABILITATION CENTER, LLC

Provider Business Mailing Address
First Line	:	PO BOX 201754
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-8112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2775 S MORELAND BLVD
Second Line	:	3RD FLOOR
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2397
Country	:	US
Telephone Number	:	216-751-8988
Fax Number	:	216-751-8990

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LAUCHLIN W. MCKEIGAN
Credential	:	D.C.
Telephone Number	:	216-751-8988

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	07/05/2016

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