| |
1501 Mentor Ave, Painesville Twp, OH 44077-1702 | |
(440) 352-3500 | |
(440) 352-3512 |
Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 1501 Mentor Ave, Painesville Twp, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285737304 | NPI | - | NPPES |
281689990002 | Other | OH | MEDICAL MUTUAL |
23797 | Medicaid | OH | |
000000179338 | Other | OH | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 1153 (Ohio) | Primary |
Mailing Address | Practice Location Address |
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1501 Mentor Ave, Painesville Twp, OH 44077-1702 Ph: (440) 352-3500 | 1501 Mentor Ave, Painesville Twp, OH 44077-1702 Ph: (440) 352-3500 |