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General NPI Number Information
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NPI Number | 1760520092
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Entity Type | Organization
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Legal Business Name | ACTIVELIFE FAMILY CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13299 SUMMERFIELD WAY
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City | PICKERINGTON
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State | OH
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Zip | 43147-9251
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Country | US
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Telephone | 614-866-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 13299 SUMMERFIELD WAY
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City | PICKERINGTON
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State | OH
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Zip | 43147-9251
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Country | US
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Telephone | 614-866-5181
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN DAVID JONES
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Credential | D.C.
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Telephone | 614-866-5181
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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 | 2191
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2117
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License Number State | OH
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