Provider Demographics
NPI:1962595017
Name:ABOOD CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:ABOOD CHIROPRACTIC CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ABOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-248-5070
Mailing Address - Street 1:6175 SOM CENTER ROAD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2941
Mailing Address - Country:US
Mailing Address - Phone:440-248-5070
Mailing Address - Fax:440-498-4620
Practice Address - Street 1:6175 SOM CENTER ROAD
Practice Address - Street 2:SUITE 140
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2941
Practice Address - Country:US
Practice Address - Phone:440-248-5070
Practice Address - Fax:440-498-4620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC.1041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5881860001Medicare NSC
OH9329591Medicare PIN