Provider Demographics
NPI:1043582984
Name:CORE HEALTH CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:CORE HEALTH CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:EAGY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-389-5461
Mailing Address - Street 1:180 W OLENTANGY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-6700
Mailing Address - Country:US
Mailing Address - Phone:614-389-5461
Mailing Address - Fax:614-389-5463
Practice Address - Street 1:180 W OLENTANGY ST
Practice Address - Street 2:SUITE A
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-6700
Practice Address - Country:US
Practice Address - Phone:614-389-5461
Practice Address - Fax:614-389-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4167111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty