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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