Provider Demographics
NPI:1902849995
Name:MILL RUN CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:MILL RUN CHIROPRACTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:D.
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:SICKLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-767-1000
Mailing Address - Street 1:3615 FISHINGER BLVD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7559
Mailing Address - Country:US
Mailing Address - Phone:614-767-1000
Mailing Address - Fax:614-767-1002
Practice Address - Street 1:3615 FISHINGER BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7559
Practice Address - Country:US
Practice Address - Phone:614-767-1000
Practice Address - Fax:614-767-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2296555Medicaid
OHMI9345231Medicare ID - Type UnspecifiedMEDICARE GROUP ID