Healthcare Provider Details

I. General information

NPI: 1346118643
Provider Name (Legal Business Name): NEWARK INTERGRADED HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W MAIN ST
NEWARK OH
43055-5008
US

IV. Provider business mailing address

3000 CORPORATE EXCHANGE DR STE 110
COLUMBUS OH
43231-0046
US

V. Phone/Fax

Practice location:
  • Phone: 614-327-7096
  • Fax:
Mailing address:
  • Phone: 614-384-0800
  • Fax: 614-384-0801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROBERT BROOKS
Title or Position: OWNER
Credential: D.C.
Phone: 614-327-7096