Provider Demographics
NPI:1013340439
Name:ADVANCED FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ADVANCED FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PIERSOL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-374-3232
Mailing Address - Street 1:PO BOX 570
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-0570
Mailing Address - Country:US
Mailing Address - Phone:740-374-3232
Mailing Address - Fax:740-374-3436
Practice Address - Street 1:326 3RD ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-2994
Practice Address - Country:US
Practice Address - Phone:740-374-3232
Practice Address - Fax:740-374-3436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty