Provider Demographics
NPI:1659486777
Name:APPLIED CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:APPLIED CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:JESSUP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-335-1551
Mailing Address - Street 1:50 TROY TOWN DR
Mailing Address - Street 2:STE B
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2341
Mailing Address - Country:US
Mailing Address - Phone:937-335-1551
Mailing Address - Fax:937-335-1288
Practice Address - Street 1:50 TROY TOWN DR
Practice Address - Street 2:STE B
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2341
Practice Address - Country:US
Practice Address - Phone:937-335-1551
Practice Address - Fax:937-335-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty