Provider Demographics
NPI:1194483826
Name:CLEVELAND CHIROPRACTIC AND REHABILITATION INC
Entity type:Organization
Organization Name:CLEVELAND CHIROPRACTIC AND REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-790-1451
Mailing Address - Street 1:4645 N LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-4042
Mailing Address - Country:US
Mailing Address - Phone:423-790-1451
Mailing Address - Fax:423-790-1252
Practice Address - Street 1:4645 N LEE HWY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-4042
Practice Address - Country:US
Practice Address - Phone:423-790-1451
Practice Address - Fax:423-790-1252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty