Provider Demographics
NPI:1346419801
Name:BLANCHARD VALLEY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BLANCHARD VALLEY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:MARRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-422-3686
Mailing Address - Street 1:228 W HARDIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3106
Mailing Address - Country:US
Mailing Address - Phone:419-422-3686
Mailing Address - Fax:419-422-3696
Practice Address - Street 1:228 W HARDIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3106
Practice Address - Country:US
Practice Address - Phone:419-422-3686
Practice Address - Fax:419-422-3696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9257241Medicare PIN