=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497014120
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STROOP CHIROPRACTIC CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2012
-----------------------------------------------------
Last Update Date | 05/15/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5770 GATEWAY STE 102
-----------------------------------------------------
City | MASON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45040-1897
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-770-3405
-----------------------------------------------------
Fax | 513-770-3406
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5770 GATEWAY STE 102
-----------------------------------------------------
City | MASON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45040-1897
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-770-3405
-----------------------------------------------------
Fax | 513-770-3406
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | DR. RICHARD GERARD JONES
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 513-770-3405
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1849
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------