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Organization
ADVANCED PHYSICIAL MEDICINE
Active
Organization
ADVANCED PHYSICIAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D BLOCK DC (PROVIDER)
(330) 345-1330
Entity
Organization
Contact information
Practice address
3431 COMMERCE PKWY STE C, WOOSTER, OH 44691-7114
(330) 345-1330
(330) 264-0003
Mailing address
1260 RIFFEL RD, WOOSTER, OH 44691-8004
(330) 345-1330
(330) 264-0003
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3561
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000377701
ANTHEM NON TRADITIONAL
OH
01
—
105707013001
MMO
OH
05
—
2601643
—
OH
01
—
AD357041
MEDICARE GROUP #
OH
Enumeration date
09/12/2006
Last updated
08/22/2020
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