Provider Demographics
NPI:1952488330
Name:HILLIARD ROME CHIROPRACTIC AND REHAB CO., P.C.
Entity Type:Organization
Organization Name:HILLIARD ROME CHIROPRACTIC AND REHAB CO., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-777-0062
Mailing Address - Street 1:2582 HILLIARD ROME RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7404
Mailing Address - Country:US
Mailing Address - Phone:614-777-0062
Mailing Address - Fax:614-777-0126
Practice Address - Street 1:2582 HILLIARD ROME RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7404
Practice Address - Country:US
Practice Address - Phone:614-777-0062
Practice Address - Fax:614-777-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1643/3715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHI9350001Medicare ID - Type Unspecified