# ADVANCED PHYSICIAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518061118
- **Authorized official:** JONATHAN D BLOCK DC (PROVIDER)
- **Authorized official phone:** (330) 345-1330

## Contact information

- **Practice address:** 3431 COMMERCE PKWY STE C, WOOSTER, OH 44691-7114
- **Practice address phone:** (330) 345-1330
- **Practice address fax:** (330) 264-0003
- **Mailing address:** 1260 RIFFEL RD, WOOSTER, OH 44691-8004
- **Mailing address phone:** (330) 345-1330
- **Mailing address fax:** (330) 264-0003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3561 | OH | Yes |

## Other

- **Enumeration date:** 09/12/2006
- **Last updated:** 08/22/2020

## 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 |