Healthcare Provider Details

I. General information

NPI: 1164577334
Provider Name (Legal Business Name): FAMILY HEALTH CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 01/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 E STATE ST
ALLIANCE OH
44601-4913
US

IV. Provider business mailing address

641 E STATE ST
ALLIANCE OH
44601-4913
US

V. Phone/Fax

Practice location:
  • Phone: 330-821-4455
  • Fax:
Mailing address:
  • Phone: 330-821-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. NICK GEORGE KOINOGLOU
Title or Position: OWNER
Credential: D.C., FIAMA, DIPL AC
Phone: 330-821-4455