Allied Chiropractic LLC
Organization Active NPI Chiropractor · Fremont, OH
NPI 1265584049 · NPPES record last updated Dec 20, 2012
Key facts
- NPI
- 1265584049
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ALLIED CHIROPRACTIC LLC
- Practice address
- 1320 E State St
Suite B
Fremont, OH 43420-4365 - Phone
- (419) 332-6840
- Fax
- (419) 332-6929
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Darren L Snodgrass
- Title
- Owner
- Phone
- (419) 332-6840
Practitioners 3
-
Kimberly R Young, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041103000747 | OH | Part B Supplier - Clinic/Group Practice | 3375505175 |
Receives reassigned benefits from 1 practitioner Practice locations: Fremont, OH |
National Provider Directory
Locations
1320 E State St
Ste B
Fremont, OH 43420
Phone (419) 332-6840
1320 E State St
Fremont, OH 43420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
1320 E State St
Suite B
Fremont, OH 43420-4365
Mailing address
1320 E State St
Suite B
Fremont, OH 43420-4365
Phone (419) 332-6840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2207632 | Medicaid | OH |
Other providers in Fremont, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.