Provider Demographics
NPI:1992911184
Name:VICARI CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:VICARI CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:VICARI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-644-2450
Mailing Address - Street 1:17793 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040
Mailing Address - Country:US
Mailing Address - Phone:937-644-2450
Mailing Address - Fax:
Practice Address - Street 1:17793 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040
Practice Address - Country:US
Practice Address - Phone:937-644-2450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty