Provider Demographics
NPI:1730233180
Name:BESSO CLINIC OF CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:BESSO CLINIC OF CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:BESSO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-689-1234
Mailing Address - Street 1:2071 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4033
Mailing Address - Country:US
Mailing Address - Phone:330-689-1234
Mailing Address - Fax:330-689-1235
Practice Address - Street 1:2071 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4033
Practice Address - Country:US
Practice Address - Phone:330-689-1234
Practice Address - Fax:330-689-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBE9356431Medicare ID - Type Unspecified