Provider Demographics
NPI:1407035827
Name:PFEIFFER CHIROPRACTIC CLINIC, INC
Entity Type:Organization
Organization Name:PFEIFFER CHIROPRACTIC CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PFEIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-647-5200
Mailing Address - Street 1:123 W HERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44090-1239
Mailing Address - Country:US
Mailing Address - Phone:440-647-5200
Mailing Address - Fax:440-647-5301
Practice Address - Street 1:123 W HERRICK AVE
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:OH
Practice Address - Zip Code:44090-1239
Practice Address - Country:US
Practice Address - Phone:440-647-5200
Practice Address - Fax:440-647-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========-00OtherBWC
OHPF0879121Medicare PIN