Healthcare Provider Details
I. General information
NPI: 1265614564
Provider Name (Legal Business Name): OXFORD CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2007
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
507 S COLLEGE AVE SUITE A
OXFORD OH
45056-2211
US
IV. Provider business mailing address
507 S COLLEGE AVE SUITE A
OXFORD OH
45056-2211
US
V. Phone/Fax
- Phone: 513-523-7118
- Fax: 513-524-2225
- Phone: 513-523-7118
- Fax: 513-524-2225
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 1213 |
| License Number State | OH |
VIII. Authorized Official
Name: MRS.
DIANE
BEARDEN
ZIPKO
Title or Position: TREASURER
Credential:
Phone: 513-523-7118