Ashtabula Chiropractic Clinic, Inc
Organization Active NPI Chiropractor · Ashtabula, OH
NPI 1811101124 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1811101124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ASHTABULA CHIROPRACTIC CLINIC, INC
- Practice address
- 2709 Lake Ave
Ashtabula, OH 44004-4959 - Phone
- (440) 998-2200
- Fax
- (440) 997-5695
- NPI assigned
- May 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Roger Saak Huang, DC
- Title
- President
- Phone
- (440) 998-2200
Practitioners 1
-
Roger Saak Huang, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040622001678 | OH | Part B Supplier - Clinic/Group Practice | 9638154743 |
Receives reassigned benefits from 1 practitioner Practice locations: Ashtabula, OH |
National Provider Directory
Locations
2794 Som Center Rd
Willoughby Hills, OH 44094
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
2709 Lake Ave
Ashtabula, OH 44004-4959
Mailing address
2709 Lake Ave
Ashtabula, OH 44004-4959
Phone (440) 998-2200
Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.