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Organization
GREAT LAKES SPORTS & SPINE LLC
Active
Organization
GREAT LAKES SPORTS & SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW PAUL MARTIN DC (OWNER/CHIROPRACTIC PHYSICIAN)
(440) 503-6683
Entity
Organization
Contact information
Practice address
34940 RIDGE RD STE B, WILLOUGHBY, OH 44094-4197
(440) 527-8030
Mailing address
502 WINDHAM CT, BROADVIEW HEIGHTS, OH 44147-4214
(440) 503-6683
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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