Provider Demographics
NPI:1609058676
Name:WALTHER CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:WALTHER CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-575-5444
Mailing Address - Street 1:1240 STATE ROUTE 28
Mailing Address - Street 2:SUITE B
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-4928
Mailing Address - Country:US
Mailing Address - Phone:513-575-5444
Mailing Address - Fax:513-575-1819
Practice Address - Street 1:1240 STATE ROUTE 28
Practice Address - Street 2:SUITE B
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-4928
Practice Address - Country:US
Practice Address - Phone:513-575-5444
Practice Address - Fax:513-575-1819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty