Provider Demographics
NPI:1760874473
Name:FARABAUGH CHIROPRACTIC OFFICE
Entity Type:Organization
Organization Name:FARABAUGH CHIROPRACTIC OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC ASST
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCLELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-898-0787
Mailing Address - Street 1:2879 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4063
Mailing Address - Country:US
Mailing Address - Phone:614-898-0787
Mailing Address - Fax:614-898-1945
Practice Address - Street 1:2879 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4063
Practice Address - Country:US
Practice Address - Phone:614-898-0787
Practice Address - Fax:614-898-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOHIO939261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRO9300211Medicare PIN