Provider Demographics
NPI:1104228576
Name:ORR, DOUGLAS
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:ORR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 KENT RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4387
Mailing Address - Country:US
Mailing Address - Phone:234-334-7194
Mailing Address - Fax:330-230-7447
Practice Address - Street 1:4411 KENT RD UNIT 4
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4387
Practice Address - Country:US
Practice Address - Phone:234-334-7194
Practice Address - Fax:330-230-7447
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor