Provider Demographics
NPI:1326578741
Name:PROHEALTH CHIROPRACTIC AND INJURY CENTER LLC
Entity Type:Organization
Organization Name:PROHEALTH CHIROPRACTIC AND INJURY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-407-1225
Mailing Address - Street 1:1329 CHERRY WAY DR STE 500
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6782
Mailing Address - Country:US
Mailing Address - Phone:614-407-1225
Mailing Address - Fax:
Practice Address - Street 1:1329 CHERRY WAY DR STE 500
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6782
Practice Address - Country:US
Practice Address - Phone:614-407-1225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty