Provider Demographics
NPI:1285256727
Name:MUNN CHIROPRACTIC
Entity type:Organization
Organization Name:MUNN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-954-9392
Mailing Address - Street 1:14 NEW HUDSON RD STE D
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9350
Mailing Address - Country:US
Mailing Address - Phone:330-954-9392
Mailing Address - Fax:
Practice Address - Street 1:14 NEW HUDSON RD STE D
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-9350
Practice Address - Country:US
Practice Address - Phone:330-954-9392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty