Provider Demographics
NPI:1013932961
Name:HEIGHTS CHIROPRACTIC PHYSICIANS, LLC
Entity Type:Organization
Organization Name:HEIGHTS CHIROPRACTIC PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-235-2225
Mailing Address - Street 1:7480 OLD TROY PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-2663
Mailing Address - Country:US
Mailing Address - Phone:937-235-2225
Mailing Address - Fax:937-237-9973
Practice Address - Street 1:7480 OLD TROY PIKE
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-2663
Practice Address - Country:US
Practice Address - Phone:937-235-2225
Practice Address - Fax:937-237-9973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3496111N00000X
OH2449111N00000X
OH731111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH433892Medicaid
OH2461518Medicaid
OH2011852Medicaid
OH2461518Medicaid
OHU81766Medicare UPIN
OHES4032291Medicare ID - Type UnspecifiedDR. CLYDE W. ESCH
OH2011852Medicaid
OHLE4032281Medicare ID - Type UnspecifiedDR. CHARLES D. LEE
OHT47043Medicare UPIN