Vivian A Conde, OTR L CST
Individual provider Active NPI Occupational Health Chiropractor · Lagrange, OH
NPI 1801001029 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801001029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Health Chiropractor 111NX0100X
- License
- 1133 (OH)
- Practice address
- 41640 Parsons Rd
Lagrange, OH 44050-9513 - Phone
- (440) 355-8032
- Fax
- (440) 355-4230
- NPI assigned
- May 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1133 | OH | MD | Occupational Health Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Health Chiropractor | 111NX0100X | 1133 | OH | Yes |
Addresses
Primary practice location
41640 Parsons Rd
Lagrange, OH 44050-9513
Mailing address
PO Box 228
Grafton, OH 44044-0228
Phone (440) 355-8032
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 341605134 | Other | OH | COMMERCIAL INSURANCE |
| 341605134-01 | Other | OH | BWC |
| 341605134005 | Other | OH | MEDICAL MUTUAL OF OHIO |
Other providers in Lagrange, OH
- Gretchen Bishop
- Cheyenne Tyler Bober
- Carlisle Township
- Mary Cham
- Brian Francis Chutes
- Sabrina Gail Conner
- Gustavo Gomez
- Marijane Sue Greene
- Timothy Michael Hall
- Lula Belle Hamilton
All providers in Lagrange, OH · Occupational Health Chiropractor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.