Provider Demographics
NPI:1962710863
Name:COMPREHENSIVE CHIROPRACTIC CARE LLC
Entity type:Organization
Organization Name:COMPREHENSIVE CHIROPRACTIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JEREMY
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-653-3710
Mailing Address - Street 1:6143 PADERBORNE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4901
Mailing Address - Country:US
Mailing Address - Phone:330-653-3710
Mailing Address - Fax:
Practice Address - Street 1:6143 PADERBORNE DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4901
Practice Address - Country:US
Practice Address - Phone:330-653-3710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty