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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Cleveland Back & Pain Mgmt | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | Provider ID: 2802695 | [sources] | |||
| NPI | 1669585428 | [sources] | |||
| Registration number | not available | [sources] | |||
| Sector | 21-Professional Medical Group | [sources] | |||
| Address | 2307 W. 14th St. S 9 S, Cleveland, OH 44113 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers excluded or suspended from Ohio's Medicaid program.
United States · ODM
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| Address | ||
|---|---|---|
| Full address | Country | |
| 2307 W. 14th St. S 9 S, Cleveland, OH 44113 | United States | |