Provider Demographics
NPI:1114085271
Name:FABRIZIO CHIROPRACTIC & PHYSICAL REHABILITATION CLINIC INC.
Entity Type:Organization
Organization Name:FABRIZIO CHIROPRACTIC & PHYSICAL REHABILITATION CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FABRIZIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-448-5533
Mailing Address - Street 1:1560 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-2578
Mailing Address - Country:US
Mailing Address - Phone:419-448-5533
Mailing Address - Fax:419-448-5559
Practice Address - Street 1:1560 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2578
Practice Address - Country:US
Practice Address - Phone:419-448-5533
Practice Address - Fax:419-448-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty