Provider Demographics
NPI:1912137605
Name:HEALING TOUCH WELLNESS AND CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HEALING TOUCH WELLNESS AND CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAZZONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-256-0799
Mailing Address - Street 1:443 W LOVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-2365
Mailing Address - Country:US
Mailing Address - Phone:513-683-2225
Mailing Address - Fax:513-683-1225
Practice Address - Street 1:443 W LOVELAND AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-2365
Practice Address - Country:US
Practice Address - Phone:513-683-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2007349Medicaid
OH6286600001OtherDME PTAN
OHMA0821232OtherPTAN
OH2007349Medicaid