Provider Demographics
NPI:1740584127
Name:KAIN CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:KAIN CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-344-4447
Mailing Address - Street 1:176 S 30TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1941
Mailing Address - Country:US
Mailing Address - Phone:740-344-4447
Mailing Address - Fax:740-344-3346
Practice Address - Street 1:176 S 30TH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1941
Practice Address - Country:US
Practice Address - Phone:740-344-4447
Practice Address - Fax:740-344-3346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0231681Medicaid
OH0231681Medicaid