Provider Demographics
NPI:1154510436
Name:STARKEY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:STARKEY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:STARKEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:D C
Authorized Official - Phone:419-289-0330
Mailing Address - Street 1:312 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3245
Mailing Address - Country:US
Mailing Address - Phone:419-289-0330
Mailing Address - Fax:419-281-5448
Practice Address - Street 1:312 CENTER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3245
Practice Address - Country:US
Practice Address - Phone:419-289-0330
Practice Address - Fax:419-281-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHST9347851Medicare PIN
OHU53474Medicare UPIN