Provider Demographics
NPI:1457994345
Name:FAIRFIELD COUNTY ACCIDENT AND INJURY CENTER, LLC
Entity Type:Organization
Organization Name:FAIRFIELD COUNTY ACCIDENT AND INJURY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNFEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-785-4689
Mailing Address - Street 1:358 LINCOLN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:358 LINCOLN AVE STE C
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3747
Practice Address - Country:US
Practice Address - Phone:740-785-4689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty