Provider Demographics
NPI:1922651603
Name:CIR IV LLC
Entity Type:Organization
Organization Name:CIR IV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MERRILL
Authorized Official - Middle Name:T
Authorized Official - Last Name:SLAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-274-2815
Mailing Address - Street 1:957 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1283
Mailing Address - Country:US
Mailing Address - Phone:614-425-5289
Mailing Address - Fax:
Practice Address - Street 1:75 N WILSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1216
Practice Address - Country:US
Practice Address - Phone:614-274-2815
Practice Address - Fax:614-732-0461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty