Healthcare Provider Details

I. General information

NPI: 1962478784
Provider Name (Legal Business Name): CHIROTHERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W MAIN ST
NEWCOMERSTOWN OH
43832-1042
US

IV. Provider business mailing address

223 W MAIN ST
NEWCOMERSTOWN OH
43832-1042
US

V. Phone/Fax

Practice location:
  • Phone: 740-498-8551
  • Fax: 740-498-4754
Mailing address:
  • Phone: 740-498-8551
  • Fax: 740-498-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC3108
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT09091
License Number StateOH

VIII. Authorized Official

Name: DR. RICHARD LEE VAN VOORHIS
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 740-498-8551