Provider Demographics
NPI:1114426434
Name:CHIROPRACTIC GROUP
Entity Type:Organization
Organization Name:CHIROPRACTIC GROUP
Other - Org Name:THE CHIROPRACTIC GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TAULBEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-380-9355
Mailing Address - Street 1:75 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-1886
Mailing Address - Country:US
Mailing Address - Phone:740-380-9355
Mailing Address - Fax:740-380-2273
Practice Address - Street 1:75 W 2ND ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138
Practice Address - Country:US
Practice Address - Phone:740-380-9355
Practice Address - Fax:740-380-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1114426434OtherNPI