Provider Demographics
NPI:1114106606
Name:COSHOCTON CHIROPRACTIC HEALTH CLINIC
Entity Type:Organization
Organization Name:COSHOCTON CHIROPRACTIC HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CATT
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:740-622-3677
Mailing Address - Street 1:649 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1634
Mailing Address - Country:US
Mailing Address - Phone:740-622-3677
Mailing Address - Fax:740-622-3631
Practice Address - Street 1:649 WALNUT ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1634
Practice Address - Country:US
Practice Address - Phone:740-622-3677
Practice Address - Fax:740-622-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0545851Medicaid
OH0545851Medicaid