Provider Demographics
NPI:1396716452
Name:REX, JAMES EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:REX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7386 MEADOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2500
Mailing Address - Country:US
Mailing Address - Phone:440-590-2693
Mailing Address - Fax:
Practice Address - Street 1:8865 BRECKSVILLE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1931
Practice Address - Country:US
Practice Address - Phone:440-546-1225
Practice Address - Fax:440-546-1226
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRE0713092Medicare ID - Type Unspecified
OHU30210Medicare UPIN