Provider Demographics
NPI:1215159009
Name:RESER CHIROPRACTIC INC
Entity type:Organization
Organization Name:RESER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:RESER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-447-3343
Mailing Address - Street 1:14 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-2720
Mailing Address - Country:US
Mailing Address - Phone:419-447-3343
Mailing Address - Fax:419-447-3436
Practice Address - Street 1:14 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2720
Practice Address - Country:US
Practice Address - Phone:419-447-3343
Practice Address - Fax:419-447-3436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0229505Medicaid
OHU60605Medicare UPIN
OH0229505Medicaid