Provider Demographics
NPI:1922272095
Name:INTEGRITY WITH CARE CHIROPRACTIC
Entity Type:Organization
Organization Name:INTEGRITY WITH CARE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BANBURY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-674-5888
Mailing Address - Street 1:16 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-1104
Mailing Address - Country:US
Mailing Address - Phone:330-674-5888
Mailing Address - Fax:330-674-9888
Practice Address - Street 1:16 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-1104
Practice Address - Country:US
Practice Address - Phone:330-674-5888
Practice Address - Fax:330-674-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000376664OtherINSURANCE
OH0498242Medicaid
OHIN9357611Medicare PIN