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General NPI Number Information
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NPI Number | 1689236325
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Entity Type | Organization
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Legal Business Name | CORE CARE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 1670 E MANSFIELD ST
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City | BUCYRUS
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State | OH
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Zip | 44820-2014
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Country | US
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Telephone | 419-562-4300
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Fax | 419-562-4303
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Provider Business Mailing Address
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Address Line | 1670 E MANSFIELD ST
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City | BUCYRUS
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State | OH
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Zip | 44820-2014
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Country | US
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Telephone | 419-562-4300
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Fax | 419-562-4303
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH R MILLER JR.
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Credential | D.C.
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Telephone | 419-562-4300
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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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