Ideal Chiropractic LLC
Organization Active NPI Clinic/Center · Huron, OH
NPI 1700445665 · NPPES record last updated Jun 13, 2019
Key facts
- NPI
- 1700445665
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- IDEAL CHIROPRACTIC LLC
- Practice address
- 2401 Sawmill Pkwy Ste 3
Huron, OH 44839-2284 - Phone
- (419) 602-1978
- NPI assigned
- Jun 13, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Brandon Paul Krueger, DC
- Title
- Majority Manager
- Phone
- (419) 602-1978
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190808002786 | OH | Part B Supplier - Clinic/Group Practice | 7214264589 |
Receives reassigned benefits from 1 practitioner Practice locations: Huron, OH |
National Provider Directory
Locations
358 Main St
Ste 3000
Huron, OH 44839
Phone (419) 602-9815
2401 Sawmill Pkwy
Ste 3
Huron, OH 44839
Phone (419) 602-1978
358 Main St
Huron, OH 44839
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
2401 Sawmill Pkwy Ste 3
Huron, OH 44839-2284
Mailing address
404 Wexford Dr
Huron, OH 44839-1463
Phone (419) 602-1978
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | brandon.krueger@myidealchiro.com | Direct |
Other providers in Huron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2019. 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.