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General NPI Number Information
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NPI Number | 1588325898
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Entity Type | Organization
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Legal Business Name | AMERICAN FAMILY CHIROPRACTIC GROUP
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Dates
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Enumeration Date | 01/08/2022
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Last Update Date | 01/08/2022
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Provider Practice Location Address
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Address Line | 5248 COURSEVIEW DR
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City | MASON
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State | OH
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Zip | 45040-2302
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Country | US
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Telephone | 513-398-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 5248 COURSEVIEW DR
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City | MASON
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State | OH
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Zip | 45040-2302
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Country | US
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Telephone | 513-398-6300
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Fax |
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | DR. MATTHEW S HAKES
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Credential | D.C.
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Telephone | 513-398-6300
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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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