1134201973 NPI number — RJF CHIROPRACTIC CENTER, INC.

Table of content: (NPI 1134201973)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134201973 NPI number — RJF CHIROPRACTIC CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RJF CHIROPRACTIC CENTER, INC.
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:
6
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:
1134201973
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
415 GLENSPRINGS DR
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45246-2317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-851-8686
Provider Business Mailing Address Fax Number:
513-851-8786

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
415 GLENSPRINGS DR
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45246-2317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-851-8686
Provider Business Practice Location Address Fax Number:
513-851-8786
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FICK
Authorized Official First Name:
RANDALL
Authorized Official Middle Name:
JON
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
513-851-8686

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1182 , 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)

  • Identifier: 9304821 . This is a "PTAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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