Provider Demographics
NPI:1891987624
Name:ALIX CHIROPRACTIC AND REHAB CENTER
Entity type:Organization
Organization Name:ALIX CHIROPRACTIC AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALIX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-791-0077
Mailing Address - Street 1:6880 PERIMETER DR STE A
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-2521
Mailing Address - Country:US
Mailing Address - Phone:614-791-0077
Mailing Address - Fax:614-791-0011
Practice Address - Street 1:6880 PERIMETER DR STE A
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-2521
Practice Address - Country:US
Practice Address - Phone:614-791-0077
Practice Address - Fax:614-791-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAL0888112Medicare PIN
OHAL9343871Medicare PIN