Provider Demographics
NPI:1619037728
Name:SPERBECK ENTERPRISES INC.
Entity Type:Organization
Organization Name:SPERBECK ENTERPRISES INC.
Other - Org Name:CENTER FOR CHIROPRACTIC ORTHOPEDICS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:SPERBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACO
Authorized Official - Phone:859-448-0900
Mailing Address - Street 1:40 N GRAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1765
Mailing Address - Country:US
Mailing Address - Phone:859-448-0900
Mailing Address - Fax:859-448-0989
Practice Address - Street 1:40 N GRAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1765
Practice Address - Country:US
Practice Address - Phone:859-448-0900
Practice Address - Fax:859-448-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100184370Medicaid
OH3137840Medicaid
OHDA9478OtherRAILROAD MEDICARE
OH3137840Medicaid
KY7100184370Medicaid
OH6639030001Medicare NSC