# CORY LAMAR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HealthSource of Rocky River
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104391515
- **Authorized official:** CORY RANDALL LAMAR (OWNER)
- **Authorized official phone:** (440) 308-7592

## Contact information

- **Practice address:** 21820 CENTER RIDGE RD, ROCKY RIVER, OH 44116-3921
- **Practice address phone:** (440) 308-7592
- **Mailing address:** 21820 CENTER RIDGE RD, ROCKY RIVER, OH 44116-3921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | Yes |
| 111NR0400X | Rehabilitation Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2018
- **Last updated:** 12/03/2018