Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Lakes Sport and Spine

Organization Chiropractor · NPI 1104500925

Great Lakes Sport and Spine is a Chiropractor in Willoughby, Ohio. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2

Practice location Address checks out

34940 Ridge Rd Ste B
Willoughby, OH 44094-4197
Phone: (440) 503-6683
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X
Acupuncturist Taxonomy 171100000X

Record details

NPI number1104500925
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Martin — Owner · (440) 503-6683
NPI enumeratedJune 12, 2023
Last updated in NPPESJune 12, 2023
Certification dateJune 12, 2023
Mailing address34940 Ridge Rd Ste B, Willoughby, OH 44094-4197

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