Provider Demographics
NPI:1396861548
Name:SCOTT GOSSELIN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SCOTT GOSSELIN CHIROPRACTIC LLC
Other - Org Name:HILLTOP WELLNESS & CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOSSELIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-279-2525
Mailing Address - Street 1:2527 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-3322
Mailing Address - Country:US
Mailing Address - Phone:614-279-2525
Mailing Address - Fax:614-272-7377
Practice Address - Street 1:2527 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3322
Practice Address - Country:US
Practice Address - Phone:614-279-2525
Practice Address - Fax:614-272-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3766111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9368711Medicare PIN