Provider Demographics
NPI:1629228747
Name:NEWTON FALLS CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:NEWTON FALLS CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHACHKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-872-1500
Mailing Address - Street 1:119 RIDGE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-1261
Mailing Address - Country:US
Mailing Address - Phone:330-872-1500
Mailing Address - Fax:330-872-1466
Practice Address - Street 1:119 RIDGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-1261
Practice Address - Country:US
Practice Address - Phone:330-872-1500
Practice Address - Fax:330-872-1466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH290747772003OtherMMOH
OH000000141154OtherBC/BS
OH000000141154OtherBC/BS