Provider Demographics
NPI:1902975931
Name:EVERHART, JOSEPH LYNN (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LYNN
Last Name:EVERHART
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 1:684 OLD STATE ROUTE 74
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245
Mailing Address - Country:US
Mailing Address - Phone:513-528-2200
Mailing Address - Fax:513-528-7991
Practice Address - Street 1:684 CINCINNATI BATAVIA PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1027
Practice Address - Country:US
Practice Address - Phone:513-528-2200
Practice Address - Fax:513-528-7991
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1224111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHEV0588934Medicare PIN