Provider Demographics
NPI:1134399850
Name:LIGHTHOUSE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:LIGHTHOUSE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:AURAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-876-0854
Mailing Address - Street 1:2135 HILLIARD ROME RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9068
Mailing Address - Country:US
Mailing Address - Phone:614-876-0854
Mailing Address - Fax:614-876-0996
Practice Address - Street 1:2135 HILLIARD ROME RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9068
Practice Address - Country:US
Practice Address - Phone:614-876-0854
Practice Address - Fax:614-876-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2206295Medicaid
OHAU4037251Medicare PIN