Provider Demographics
NPI:1598206757
Name:RIVERSIDE CHIROPRACTIC CENTER, INC
Entity Type:Organization
Organization Name:RIVERSIDE CHIROPRACTIC CENTER, INC
Other - Org Name:KIRK L SCHOENMAN DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHOENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-547-0160
Mailing Address - Street 1:7100 N HIGH ST
Mailing Address - Street 2:STE 202
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2316
Mailing Address - Country:US
Mailing Address - Phone:614-547-0160
Mailing Address - Fax:614-547-0161
Practice Address - Street 1:7100 N HIGH ST
Practice Address - Street 2:STE 202
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2316
Practice Address - Country:US
Practice Address - Phone:614-547-0160
Practice Address - Fax:614-547-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1108261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0616275Medicaid