Provider Demographics
NPI:1972749778
Name:LANAHAN CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:LANAHAN CHIROPRACTIC INC.
Other - Org Name:WITHAMSVILLE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-753-0066
Mailing Address - Street 1:901 OHIO PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-2322
Mailing Address - Country:US
Mailing Address - Phone:513-753-0066
Mailing Address - Fax:513-943-2541
Practice Address - Street 1:901 OHIO PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-2322
Practice Address - Country:US
Practice Address - Phone:513-753-0066
Practice Address - Fax:513-943-2541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0806364Medicaid
U12835Medicare UPIN
OH0806364Medicaid