Organization
HEATH ACTIVE SPINE & REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GUSTAFSON DC (MEMBER)
(440) 319-5520
Entity
Organization
Contact information
Practice address
838 S 30TH ST, HEATH, OH 43056-1254
(740) 522-6300
(740) 522-6308
Mailing address
838 S 30TH ST, HEATH, OH 43056-1254
(740) 522-6300
(740) 522-6308
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-04383
OH
Other
Enumeration date
07/13/2017
Last updated
07/21/2022
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