MEDICARE: POTENT 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

General Provider Information

NPI Number	:	1982322780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POTENT CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	6826 ALBANY WOODS BLVD
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-9387
Country	:	US
Telephone Number	:	419-569-6095
Fax Number	:

Provider Business Practice Location Address
First Line	:	5579 N HAMILTON RD
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-1321
Country	:	US
Telephone Number	:	419-569-6095
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TYLOR PRITCHARD
Credential	:	DC
Telephone Number	:	419-569-6095

Provider Enumeration Date	:	08/17/2022
Last Update Date	:	08/17/2022

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Directions to “POTENT CHIROPRACTIC LLC ” Practice Location

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