Provider Demographics
NPI:1851455463
Name:ZANESVILLE CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:ZANESVILLE CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCNEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-450-9000
Mailing Address - Street 1:PO BOX 8132
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-8132
Mailing Address - Country:US
Mailing Address - Phone:740-450-9000
Mailing Address - Fax:740-450-2494
Practice Address - Street 1:1400 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1083
Practice Address - Country:US
Practice Address - Phone:740-450-9000
Practice Address - Fax:740-450-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1607111N00000X, 111N00000X
OH3148111N00000X
OH35-0830122085R0202X
OHPT-10506225100000X
OHPT-007993225100000X
OHPT.007723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHZA9315431Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER