Provider Demographics
NPI:1912395963
Name:VALLI-MELVIN CHIROPRACTIC AND OCCUPATIONAL REHABILITATION CENTER
Entity Type:Organization
Organization Name:VALLI-MELVIN CHIROPRACTIC AND OCCUPATIONAL REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-464-1653
Mailing Address - Street 1:1420 CHILLICOTHE ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3444
Mailing Address - Country:US
Mailing Address - Phone:740-354-8824
Mailing Address - Fax:740-354-8826
Practice Address - Street 1:1420 CHILLICOTHE ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3444
Practice Address - Country:US
Practice Address - Phone:740-354-8824
Practice Address - Fax:740-354-8826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11652526OtherCAQH
OH1124109111OtherNPI
OH0130562Medicaid