Organization
PRO FAMILY CHIROPRACTIC CENTER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA M PROVENZA-TABAK D.C. (DOCTOR OF CHIROPRACTIC)
(330) 702-0500
Entity
Organization
Contact information
Practice address
3680 STARRS CENTRE DR, CANFIELD, OH 44406-9514
(330) 702-0500
(330) 702-0575
Mailing address
3680 STARRS CENTRE DR, CANFIELD, OH 44406-9514
(330) 702-0500
(330) 702-0575
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2661
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2062888
—
OH
Enumeration date
07/14/2008
Last updated
07/14/2008
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