Provider Demographics
NPI:1285853929
Name:COLE FAMILY CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:COLE FAMILY CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-855-5454
Mailing Address - Street 1:68 N HIGH ST
Mailing Address - Street 2:SUITE E-106
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8915
Mailing Address - Country:US
Mailing Address - Phone:614-855-5454
Mailing Address - Fax:614-283-5400
Practice Address - Street 1:68 N HIGH ST
Practice Address - Street 2:SUITE E-106
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8915
Practice Address - Country:US
Practice Address - Phone:614-855-5454
Practice Address - Fax:614-283-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2760111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2269610Medicaid
OH2269610Medicaid
OHU85129Medicare UPIN