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Organization
LAKE COUNTY CHIROPRACTIC INC
Active
Organization
LAKE COUNTY CHIROPRACTIC INC
Active
Other names
Beth Ann Moon
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETH ANN MOON DC (OWNER PRESIDENT)
(440) 352-3500
Entity
Organization
Contact information
Practice address
1501 MENTOR AVE, PAINESVILLE TWP, OH 44077-1702
(440) 352-3500
(440) 352-3512
Mailing address
1501 MENTOR AVE, PAINESVILLE TWP, OH 44077-1702
(440) 352-3500
(440) 352-3512
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1153
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179338
ANTHEM
OH
05
—
23797
—
OH
01
—
281689990002
MEDICAL MUTUAL
OH
Enumeration date
09/06/2006
Last updated
08/22/2020
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