Provider Demographics
NPI:1922150168
Name:VARNEY CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:VARNEY CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:VARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-477-5654
Mailing Address - Street 1:4865 TUSCARAWAS STREET WEST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708
Mailing Address - Country:US
Mailing Address - Phone:330-477-5654
Mailing Address - Fax:330-478-8040
Practice Address - Street 1:4865 TUSCARAWAS STREET WEST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708
Practice Address - Country:US
Practice Address - Phone:330-477-5654
Practice Address - Fax:330-478-8040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADA3721OtherMEDICARE GROUP
GAP00056870OtherMEDICARE
OH0580652Medicaid
GAP00056870OtherMEDICARE
GAP00056870OtherMEDICARE
OH=========00OtherWOKERS COMP
GADA3721OtherMEDICARE GROUP