Provider Demographics
NPI:1508268640
Name:BRANDT PIKE CHIROPRACTIC AND REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:BRANDT PIKE CHIROPRACTIC AND REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-813-3801
Mailing Address - Street 1:7460 BRANDT PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3240
Mailing Address - Country:US
Mailing Address - Phone:937-813-3801
Mailing Address - Fax:937-281-0666
Practice Address - Street 1:7460 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3240
Practice Address - Country:US
Practice Address - Phone:937-567-7888
Practice Address - Fax:937-281-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty