Healthcare Provider Details
I. General information
NPI: 1205422821
Provider Name (Legal Business Name): ARTHRITIS AND JOINT PAIN RELIEF CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2020
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4002 N HAMPTON DR
POWELL OH
43065-8444
US
IV. Provider business mailing address
4002 N HAMPTON DR
POWELL OH
43065-8444
US
V. Phone/Fax
- Phone: 614-389-0994
- Fax: 614-845-3216
- Phone: 614-389-0994
- Fax: 614-845-3216
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
M
ESTERLE
Title or Position: MEDICAL DIRECTOR / OWNER
Credential: DO
Phone: 330-331-7207