NPIMap

Organization Active NPI

Detrick Chiropractic LLC

  • Chiropractor
  • Fort Loramie, OH
National Provider Identifier
1841464088
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2482 Issued in OH
Legal business name
DETRICK CHIROPRACTIC LLC
Practice address
406 South Main Street
Fort Loramie, OH 45845-0260
Phone
(937) 420-4000
Fax
(937) 420-4001
NPI assigned
Apr 18, 2008
Last updated
Apr 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dustin J Detrick, D.C., L.C.P.NPI 1699840512
Title
Owner
Phone
(937) 420-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2482 OH Primary

Addresses

Primary practice location

406 South Main Street
Fort Loramie, OH 45845-0260

Mailing address

PO Box 260
406 South Main Street
Fort Loramie, OH 45845-0260
Phone (937) 420-4000

National Provider Directory

National Provider Directory

Locations

406 S Main St
Fort Loramie, OH 45845
Phone (937) 420-4000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1841464088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "address_2": "406 SOUTH MAIN STREET",
            "city": "FORT LORAMIE",
            "state": "OH",
            "postal_code": "458450260",
            "telephone_number": "937-420-4000",
            "fax_number": "937-420-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SOUTH MAIN STREET",
            "city": "FORT LORAMIE",
            "state": "OH",
            "postal_code": "458450260",
            "telephone_number": "937-420-4000",
            "fax_number": "937-420-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETRICK CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "DETRICK",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-420-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., L.C.P."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Loramie, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.