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General NPI Number Information
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NPI Number | 1649462128
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Entity Type | Organization
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Legal Business Name | CROSS COUNTY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 9201 MONTGOMERY RD
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City | MONTGOMERY
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State | OH
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Zip | 45242-7750
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Country | US
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Telephone | 513-984-5454
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Fax | 513-984-5722
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Provider Business Mailing Address
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Address Line | 9201 MONTGOMERY RD
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City | MONTGOMERY
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State | OH
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Zip | 45242-7750
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Country | US
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Telephone | 513-984-5454
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Fax | 513-984-5722
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RICHARD M SAWICKI
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Credential | D.C.
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Telephone | 513-984-5454
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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 | 1291
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License Number State | OH
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