Healthcare Provider Details

I. General information

NPI: 1114106606
Provider Name (Legal Business Name): COSHOCTON CHIROPRACTIC HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

649 WALNUT ST
COSHOCTON OH
43812-1634
US

IV. Provider business mailing address

649 WALNUT ST
COSHOCTON OH
43812-1634
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-3677
  • Fax: 740-622-3631
Mailing address:
  • Phone: 740-622-3677
  • Fax: 740-622-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS CINDY CATT
Title or Position: OFFICE MANAGER
Credential: OFFICE MANAGER
Phone: 740-622-3677