Provider Demographics
NPI:1679725865
Name:BIRCH, JUDD (DC)
Entity Type:Individual
Prefix:DR
First Name:JUDD
Middle Name:
Last Name:BIRCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 WHEELING AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2340
Mailing Address - Country:US
Mailing Address - Phone:740-255-5427
Mailing Address - Fax:740-255-5441
Practice Address - Street 1:927 WHEELING AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2340
Practice Address - Country:US
Practice Address - Phone:740-255-5427
Practice Address - Fax:740-255-5441
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3872111N00000X
CA32732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor