Provider Demographics
NPI:1063542306
Name:CLEVELAND CHIROPRACTIC ASSOCIATES, INC.
Entity type:Organization
Organization Name:CLEVELAND CHIROPRACTIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:BERT
Authorized Official - Last Name:VECHIARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-250-9072
Mailing Address - Street 1:853 WESTPOINT PKWY
Mailing Address - Street 2:SUITE 750
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1532
Mailing Address - Country:US
Mailing Address - Phone:440-250-9072
Mailing Address - Fax:440-250-9105
Practice Address - Street 1:853 WESTPOINT PKWY
Practice Address - Street 2:SUITE 750
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1532
Practice Address - Country:US
Practice Address - Phone:440-250-9072
Practice Address - Fax:440-250-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3227111N00000X
OH3145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCL9319551Medicare ID - Type Unspecified