Healthcare Provider Details

I. General information

NPI: 1730505041
Provider Name (Legal Business Name): CENTRAL OHIO SPINE AND JOINT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 PARK MEADOW RD
WESTERVILLE OH
43081-2871
US

IV. Provider business mailing address

768 PARK MEADOW RD
WESTERVILLE OH
43081-2871
US

V. Phone/Fax

Practice location:
  • Phone: 614-392-2732
  • Fax: 614-392-2792
Mailing address:
  • Phone: 614-392-2732
  • Fax: 614-392-2792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4149
License Number StateOH

VIII. Authorized Official

Name: DR. DANIEL LEONARD
Title or Position: OWNER
Credential: DC
Phone: 614-392-2732