330 Chiropractic LLC
Organization Active NPI Chiropractor · Boardman, OH
NPI 1497219463 · NPPES record last updated Aug 14, 2019
Key facts
- NPI
- 1497219463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- 330 CHIROPRACTIC LLC
- Practice address
- 1280 Boardman Canfield Rd Ste 1
Boardman, OH 44512-4073 - Phone
- (330) 360-6264
- NPI assigned
- Jan 24, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Kyle Muir, DC
- Title
- Chiropractor
- Phone
- (330) 953-1330
Practitioners 1
-
Kyle Seth Muir, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190220001348 | OH | Part B Supplier - Clinic/Group Practice | 6204174014 |
Receives reassigned benefits from 1 practitioner Practice locations: Boardman, OH |
National Provider Directory
Locations
1280 Boardman Canfield Rd
Ste 1
Boardman, OH 44512
Phone (330) 360-6264
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
1280 Boardman Canfield Rd Ste 1
Boardman, OH 44512-4073
Mailing address
1280 Boardman Canfield Rd Ste 1
Boardman, OH 44512-4073
Phone (330) 360-6264
Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.