Healthcare Provider Details

I. General information

NPI: 1235455387
Provider Name (Legal Business Name): WESTERVILLE CHIROPRACTIC & PHYSICAL THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 W SCHROCK RD
WESTERVILLE OH
43081-2890
US

IV. Provider business mailing address

191 W SCHROCK RD
WESTERVILLE OH
43081-2890
US

V. Phone/Fax

Practice location:
  • Phone: 614-384-0080
  • Fax: 614-384-0081
Mailing address:
  • Phone: 614-384-0800
  • Fax: 614-384-0801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number3262
License Number StateOH

VIII. Authorized Official

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