Healthcare Provider Details

I. General information

NPI: 1497923726
Provider Name (Legal Business Name): CINCINNATI CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 HARRISON AVE
CINCINNATI OH
45211-4639
US

IV. Provider business mailing address

4021 HARRISON AVE
CINCINNATI OH
45211-4639
US

V. Phone/Fax

Practice location:
  • Phone: 513-661-6666
  • Fax:
Mailing address:
  • Phone: 513-661-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3386
License Number StateOH

VIII. Authorized Official

Name: DR. ANDREW JASON LIMLE
Title or Position: OWNER
Credential: DC
Phone: 513-661-6666