Provider Demographics
NPI:1578616033
Name:PURVIS ARCHER, ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:PURVIS ARCHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-1359
Mailing Address - Country:US
Mailing Address - Phone:740-732-7050
Mailing Address - Fax:740-732-4837
Practice Address - Street 1:111 WEST ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-1359
Practice Address - Country:US
Practice Address - Phone:740-732-7050
Practice Address - Fax:740-732-4837
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2519386Medicaid
OH56248594300OtherWORKERS COMP
OHCO3527OtherHEALTH PLAN
OH000000351472OtherBLUE CROSS BLUE SHIELD
OH56248594300OtherWORKERS COMP
OH2519386Medicaid