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General NPI Number Information
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NPI Number | 1528267986
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Entity Type | Organization
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Legal Business Name | FAMILY TREE CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 8241 CORNELL RD SUITE 220
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City | CINCINNATI
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State | OH
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Zip | 45249-2235
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Country | US
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Telephone | 513-777-0024
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Fax | 513-777-0036
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Provider Business Mailing Address
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Address Line | 8241 CORNELL RD SUITE 220
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City | CINCINNATI
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State | OH
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Zip | 45249-2235
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Country | US
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Telephone | 513-777-0024
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Fax | 513-777-0036
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY M PITMAN
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Credential | DO
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Telephone | 513-777-0027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1095
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License Number State | OH
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