Provider Demographics
NPI:1861534125
Name:FORTUNA, JOHN R (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:FORTUNA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:6900 RIDGE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5650
Mailing Address - Country:US
Mailing Address - Phone:440-888-4526
Mailing Address - Fax:440-888-9102
Practice Address - Street 1:6900 RIDGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5650
Practice Address - Country:US
Practice Address - Phone:440-888-4526
Practice Address - Fax:440-888-9102
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH3343111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation