Provider Demographics
NPI:1043494990
Name:TRANQUILITY SPINAL CARE, LLC
Entity Type:Organization
Organization Name:TRANQUILITY SPINAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-738-9888
Mailing Address - Street 1:1103 GARDENIA DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-1084
Mailing Address - Country:US
Mailing Address - Phone:419-738-9888
Mailing Address - Fax:419-738-9895
Practice Address - Street 1:1103 GARDENIA DR
Practice Address - Street 2:SUITE 2
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-1084
Practice Address - Country:US
Practice Address - Phone:419-738-9888
Practice Address - Fax:419-738-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty