Provider Demographics
NPI:1356519292
Name:CHAPEL HILL CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:CHAPEL HILL CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-630-1500
Mailing Address - Street 1:1520 HOME AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-1600
Mailing Address - Country:US
Mailing Address - Phone:330-630-1500
Mailing Address - Fax:330-630-9303
Practice Address - Street 1:1520 HOME AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1600
Practice Address - Country:US
Practice Address - Phone:330-630-1500
Practice Address - Fax:330-630-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0756892Medicaid
OH0756892Medicaid
OHCH9246051Medicare PIN
OHT43551Medicare UPIN