Provider Demographics
NPI:1003252560
Name:HARVILLE CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:HARVILLE CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:HARVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-791-0663
Mailing Address - Street 1:3967 PRESIDENTIAL PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7268
Mailing Address - Country:US
Mailing Address - Phone:614-791-0663
Mailing Address - Fax:614-791-8199
Practice Address - Street 1:3967 PRESIDENTIAL PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7268
Practice Address - Country:US
Practice Address - Phone:614-791-0663
Practice Address - Fax:614-791-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU60070Medicare UPIN