Provider Demographics
NPI:1114100823
Name:DENTON-PRATER CHIROPRACTIC AND NATURAL HEALTH
Entity Type:Organization
Organization Name:DENTON-PRATER CHIROPRACTIC AND NATURAL HEALTH
Other - Org Name:DENTON-PRATER CHIROPRACTIC AND NATURAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DENTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-387-3185
Mailing Address - Street 1:520 E CENTER ST STE A
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4261
Mailing Address - Country:US
Mailing Address - Phone:740-387-3185
Mailing Address - Fax:740-387-4238
Practice Address - Street 1:520 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4260
Practice Address - Country:US
Practice Address - Phone:740-387-3185
Practice Address - Fax:740-387-4238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0433043Medicaid