1396080404 NPI number — KRAFT PERFORMANCE CHIROPRACTIC LLC

Table of content: DENNIS SCOTT WOOLEY ARNP (NPI 1184628075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396080404 NPI number — KRAFT PERFORMANCE CHIROPRACTIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KRAFT PERFORMANCE CHIROPRACTIC LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396080404
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7239 SAWMILL RD
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43016-5000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-761-8115
Provider Business Mailing Address Fax Number:
614-761-9993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7239 SAWMILL RD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43016-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-761-8115
Provider Business Practice Location Address Fax Number:
614-761-9993
Provider Enumeration Date:
11/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KRAFT
Authorized Official First Name:
BENJAMIN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
614-761-8115

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  4340 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com