MEDICARE: CHIROPRACTIC AND PHYSICAL THERAPY CENTERS OF OHIO- NORTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1386950111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC AND PHYSICAL THERAPY CENTERS OF OHIO- NORTH LLC

Provider Business Mailing Address
First Line	:	2218 STRINGTOWN RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2929
Country	:	US
Telephone Number	:	614-471-3500
Fax Number	:	614-471-4504

Provider Business Practice Location Address
First Line	:	4410 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-5803
Country	:	US
Telephone Number	:	614-471-3500
Fax Number	:	614-471-4504

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MRS. KARLA TALLEDO
Credential	:
Telephone Number	:	614-277-1248

Provider Enumeration Date	:	08/31/2010
Last Update Date	:	01/11/2011

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