Provider Demographics
NPI:1649698663
Name:OHM FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:OHM FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OHM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-565-8823
Mailing Address - Street 1:232 MYSTIC LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5316
Mailing Address - Country:US
Mailing Address - Phone:610-565-8823
Mailing Address - Fax:610-565-4098
Practice Address - Street 1:327 N MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-4421
Practice Address - Country:US
Practice Address - Phone:610-565-8823
Practice Address - Fax:610-565-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty