Provider Demographics
NPI:1871861930
Name:VASCURA CHIROPRACTIC & REHABILITATION CENTER
Entity Type:Organization
Organization Name:VASCURA CHIROPRACTIC & REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VASCURA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-455-5555
Mailing Address - Street 1:2110 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2025
Mailing Address - Country:US
Mailing Address - Phone:740-455-5555
Mailing Address - Fax:740-455-4648
Practice Address - Street 1:2110 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2025
Practice Address - Country:US
Practice Address - Phone:740-455-5555
Practice Address - Fax:740-455-4648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2835261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHVA0873801OtherMEDICARE PTAN
OHU75077Medicare UPIN