Provider Demographics
NPI:1497014120
Name:STROOP CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:STROOP CHIROPRACTIC CENTER INC
Other - Org Name:CROSSING CHIROPRACTIC & MASSAGE WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-770-3405
Mailing Address - Street 1:5770 GATEWAY
Mailing Address - Street 2:STE 102
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1897
Mailing Address - Country:US
Mailing Address - Phone:513-770-3405
Mailing Address - Fax:513-770-3406
Practice Address - Street 1:5770 GATEWAY
Practice Address - Street 2:STE 102
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1897
Practice Address - Country:US
Practice Address - Phone:513-770-3405
Practice Address - Fax:513-770-3406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0950725Medicaid
OHU42014Medicare UPIN