Healthcare Provider Details

I. General information

NPI: 1255543385
Provider Name (Legal Business Name): KREUSCH CHIROPRACTIC CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ONE HALF NORTH MAIN STREET
ARCANUM OH
45304-1401
US

IV. Provider business mailing address

601 ONE HALF NORTH MAIN STREET
ARCANUM OH
45304-1401
US

V. Phone/Fax

Practice location:
  • Phone: 937-692-8570
  • Fax: 937-692-8570
Mailing address:
  • Phone: 937-692-8570
  • Fax: 937-692-8570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1951
License Number StateOH

VIII. Authorized Official

Name: DR. DANIEL R. KREUSCH
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 937-692-8570