Provider Demographics
NPI:1053637660
Name:MCGOUGH DEVELOPMENT LLC
Entity Type:Organization
Organization Name:MCGOUGH DEVELOPMENT LLC
Other - Org Name:ACUHEALTH CHIROPRACTIC &WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MCGOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-475-2992
Mailing Address - Street 1:5980 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2200
Mailing Address - Country:US
Mailing Address - Phone:614-475-2992
Mailing Address - Fax:614-475-2993
Practice Address - Street 1:5980 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2200
Practice Address - Country:US
Practice Address - Phone:614-475-2992
Practice Address - Fax:614-475-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3523111N00000X
OH0007171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V00349Medicare UPIN