Provider Demographics
NPI:1407133937
Name:NOEL
Entity Type:Organization
Organization Name:NOEL
Other - Org Name:COMPREHENSIVE CHIROPRACTIC CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-369-4349
Mailing Address - Street 1:575 SUNBURY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9795
Mailing Address - Country:US
Mailing Address - Phone:740-369-4349
Mailing Address - Fax:740-369-3290
Practice Address - Street 1:575 SUNBURY RD
Practice Address - Street 2:SUITE A
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9795
Practice Address - Country:US
Practice Address - Phone:740-369-4349
Practice Address - Fax:740-369-3290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2321111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0307135Medicaid
U72026Medicare UPIN
OH0307135Medicaid