Provider Demographics
NPI:1518133651
Name:LAURIE JAHNKE, D.C.
Entity Type:Organization
Organization Name:LAURIE JAHNKE, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-931-4300
Mailing Address - Street 1:8624 WINTON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4837
Mailing Address - Country:US
Mailing Address - Phone:513-931-4300
Mailing Address - Fax:513-898-9149
Practice Address - Street 1:8624 WINTON RD
Practice Address - Street 2:SUITE B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4837
Practice Address - Country:US
Practice Address - Phone:513-931-4300
Practice Address - Fax:513-898-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHV10901Medicare UPIN