MEDICARE: IRVINE CHIROPRACTIC 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	2727	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447478094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRVINE CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	1219 COUNTY LINE ROAD, SUITE C
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-6001
Country	:	US
Telephone Number	:	614-839-2225
Fax Number	:	614-891-8875

Provider Business Practice Location Address
First Line	:	1219 COUNTY LINE ROAD, SUITE C
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-6001
Country	:	US
Telephone Number	:	614-839-2225
Fax Number	:	614-891-8875

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	STEVEN B IRVINE
Credential	:	D.C.
Telephone Number	:	614-839-2225

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/20/2022

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Directions to “IRVINE CHIROPRACTIC LLC ” Practice Location

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