GREAT LAKES PHYSICAL MEDICINE LLC
NPI 1356973267
Chiropractor in Beachwood, OH

Q: What is Great Lakes Physical Medicine LLC's NPI number?

The NPI number for Great Lakes Physical Medicine LLC is 1356973267. It was assigned to this organization in the NPPES registry on February 8, 2020.

Q: What is Great Lakes Physical Medicine LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since February 08, 2020

25200 CHAGRIN BLVD STE 103, BEACHWOOD, OH 44122(570) 575-5414 Get Directions Write a Review

NPPES record last updated: February 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Great Lakes Physical Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES PHYSICAL MEDICINE LLC (NPI 1356973267) is a healthcare organization registered as a chiropractor in Beachwood, Ohio and active in the NPI registry since February 2020. The organization lists Eric D Wolk, Owner, as its authorized official.

NPPES Registry Identity

NPI1356973267

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameGREAT LAKES PHYSICAL MEDICINE LLC

Location Address25200 CHAGRIN BLVD STE 103Beachwood, OH 44122-5681

Mailing Address25200 Chagrin Blvd Ste 103Beachwood, OH 44122-5681 · (570) 575-5414

Phone(570) 575-5414

Organization SubpartNo

Authorized OfficialEric D WolkOwner · (570) 575-5414

Enumeration DateFebruary 8, 2020

✔ NPI 1356973267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Also ListedClinic/Center · Physical TherapyTaxonomy 261QP2000X

25200 CHAGRIN BLVD STE 103, Beachwood, OH 44122

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Other Identifiers 1

Medicaid0281891OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNE MARGARET KINCHEN

Acupuncturist

25200 CHAGRIN BLVD STE 103
BEACHWOOD, OH 44122

Cuyahoga County (216) 292-9698

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Physical Medicine LLC's NPI number?

The NPI number for Great Lakes Physical Medicine LLC is 1356973267. It was assigned to this organization in the NPPES registry on February 8, 2020.

Where is Great Lakes Physical Medicine LLC located?

Great Lakes Physical Medicine LLC is located at 25200 Chagrin Blvd Ste 103, Beachwood, OH 44122. The listed phone number is (570) 575-5414.

What is Great Lakes Physical Medicine LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Great Lakes Physical Medicine LLC was last updated on February 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.