Provider Demographics
NPI:1083808729
Name:KENNETH J LAUX, JR, CIRCLEVILLE CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:KENNETH J LAUX, JR, CIRCLEVILLE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAUX
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:740-477-3333
Mailing Address - Street 1:420 LANCASTER PIKE
Mailing Address - Street 2:PO BOX 118
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-9272
Mailing Address - Country:US
Mailing Address - Phone:740-477-3333
Mailing Address - Fax:740-477-1100
Practice Address - Street 1:420 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-9272
Practice Address - Country:US
Practice Address - Phone:740-477-3333
Practice Address - Fax:740-477-1100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH004548590OtherAETNA
OH087605437009OtherMEDICAL MUTUAL
OH000000120411OtherANTHEM
OH4400075OtherUHC
OH0582392Medicaid
OH087605437009OtherMEDICAL MUTUAL
OH000000120411OtherANTHEM