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General NPI Number Information
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NPI Number | 1578180774
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Entity Type | Organization
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Legal Business Name | POWELL CHIROPRACTIC & WELLNESS LLC
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 47 CLAIREDAN DR
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City | POWELL
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State | OH
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Zip | 43065-8064
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Country | US
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Telephone | 614-505-8600
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Fax | 614-505-6025
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Provider Business Mailing Address
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Address Line | 47 CLAIREDAN DR
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City | POWELL
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State | OH
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Zip | 43065-8064
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Country | US
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Telephone | 614-505-8600
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Fax | 614-505-6025
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Authorized Official
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Title or Position | DC
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Name | DANIEL E LARA
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Credential | DC
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Telephone | 614-505-8600
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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 |
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License Number State |
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