Provider Demographics
NPI:1376909986
Name:TYLERSVILLE RD CHIROPRACTIC AND REHAB
Entity Type:Organization
Organization Name:TYLERSVILLE RD CHIROPRACTIC AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-305-5064
Mailing Address - Street 1:3501 TYLERSVILLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8096
Mailing Address - Country:US
Mailing Address - Phone:513-816-7519
Mailing Address - Fax:513-816-7575
Practice Address - Street 1:3683 GARDEN CT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2906
Practice Address - Country:US
Practice Address - Phone:614-305-5064
Practice Address - Fax:614-801-9095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty