Provider Demographics
NPI:1023554474
Name:VARCKETTE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:VARCKETTE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:VARCKETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-888-2225
Mailing Address - Street 1:870 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4139
Mailing Address - Country:US
Mailing Address - Phone:614-888-2225
Mailing Address - Fax:614-847-1348
Practice Address - Street 1:870 HIGH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4139
Practice Address - Country:US
Practice Address - Phone:614-888-2225
Practice Address - Fax:614-847-1348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3044261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4035621Medicare PIN