Cleveland Performance Chiropractic, Llc | |
15713 Detroit Ave Lakewood OH 44107-3709 | |
(330) 554-4232 | |
Not Available |
Full Name | Cleveland Performance Chiropractic, Llc |
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Speciality | Clinic/Center |
Location | 15713 Detroit Ave, Lakewood, Ohio |
Authorized Official Name and Position | Kevin Burroughs (OWNER) |
Authorized Official Contact | 3305544232 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cleveland Performance Chiropractic, Llc 6018 Madison Ave Cleveland OH 44102-4356 Ph: () - | Cleveland Performance Chiropractic, Llc 15713 Detroit Ave Lakewood OH 44107-3709 Ph: (330) 554-4232 |
NPI Number | 1568002137 |
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Provider Enumeration Date | 01/13/2020 |
Last Update Date | 10/28/2020 |
Medicare PECOS PAC ID | 7517392939 |
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Medicare Enrollment ID | O20231016001948 |
Identifier | Type | State | Issuer |
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1568002137 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Kevin Burroughs |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1578070280 PECOS PAC ID: 4789019100 Enrollment ID: I20231016002058 |
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