Provider Demographics
NPI:1821143322
Name:FARRELL CHIROPRACTIC INC
Entity Type:Organization
Organization Name:FARRELL CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-293-0760
Mailing Address - Street 1:3809 WILMINGTON PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5096
Mailing Address - Country:US
Mailing Address - Phone:937-293-0760
Mailing Address - Fax:937-293-0763
Practice Address - Street 1:3809 WILMINGTON PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-5096
Practice Address - Country:US
Practice Address - Phone:937-293-0760
Practice Address - Fax:937-293-0763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHFA9343071Medicare ID - Type Unspecified