Provider Demographics
NPI:1528205762
Name:CHAD E. GUESS D.C. LLC
Entity Type:Organization
Organization Name:CHAD E. GUESS D.C. LLC
Other - Org Name:FIVE POINT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-622-3553
Mailing Address - Street 1:1101 CHESTNUT ST
Mailing Address - Street 2:PO BOX 687
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1323
Mailing Address - Country:US
Mailing Address - Phone:740-622-3553
Mailing Address - Fax:740-622-5270
Practice Address - Street 1:1101 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1323
Practice Address - Country:US
Practice Address - Phone:740-622-3553
Practice Address - Fax:740-622-5270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2009150Medicaid
OHGU0829421Medicare PIN
OH2009150Medicaid