Provider Demographics
NPI:1104962760
Name:FINE, HALBERT C (DC)
Entity type:Individual
Prefix:DR
First Name:HALBERT
Middle Name:C
Last Name:FINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2852 BOUDINOT AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2461
Mailing Address - Country:US
Mailing Address - Phone:513-662-2273
Mailing Address - Fax:513-662-1597
Practice Address - Street 1:2852 BOUDINOT AVE STE 201
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2461
Practice Address - Country:US
Practice Address - Phone:513-662-2273
Practice Address - Fax:513-662-1597
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU36267Medicare UPIN