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General NPI Number Information
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NPI Number | 1982818340
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Entity Type | Organization
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Legal Business Name | FAMILY CHIROPRACTIC CENTER OF LOGAN CO. INC.
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 412 E COLUMBUS AVE
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-2004
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Country | US
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Telephone | 937-593-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 412 E COLUMBUS AVE
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-2004
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Country | US
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Telephone | 937-593-7711
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES THOMAS TASSELL
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Credential |
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Telephone | 937-593-7711
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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 | 1492
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License Number State | OH
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