Provider Demographics
NPI:1063626372
Name:EAST KEMPER CHIROPRACTIC INC
Entity type:Organization
Organization Name:EAST KEMPER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROTTINGHAUS
Authorized Official - Suffix:X
Authorized Official - Credentials:DC
Authorized Official - Phone:513-772-3500
Mailing Address - Street 1:11570 LIPPELMAN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3916
Mailing Address - Country:US
Mailing Address - Phone:513-772-3500
Mailing Address - Fax:513-772-3511
Practice Address - Street 1:11570 LIPPELMAN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3916
Practice Address - Country:US
Practice Address - Phone:513-772-3500
Practice Address - Fax:513-772-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0945080Medicaid
OH6648110001OtherMEDICARE DME
KY85001659Medicaid
KY85001659Medicaid
OH9307091Medicare PIN