Provider Demographics
NPI:1396326617
Name:KIRTLAND CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:KIRTLAND CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-840-8357
Mailing Address - Street 1:9181 CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:KIRTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9263
Mailing Address - Country:US
Mailing Address - Phone:440-744-9009
Mailing Address - Fax:
Practice Address - Street 1:9181 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:KIRTLAND
Practice Address - State:OH
Practice Address - Zip Code:44094-9263
Practice Address - Country:US
Practice Address - Phone:440-744-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty