Provider Demographics
NPI:1497947089
Name:REGIEC CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:REGIEC CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:REGIEC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-260-0062
Mailing Address - Street 1:7050 ENGLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-8406
Mailing Address - Country:US
Mailing Address - Phone:440-260-0062
Mailing Address - Fax:440-260-0125
Practice Address - Street 1:7050 ENGLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-8406
Practice Address - Country:US
Practice Address - Phone:440-260-0062
Practice Address - Fax:440-260-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRE 9340741Medicare UPIN