Provider Demographics
NPI:1205988151
Name:RIVER CITY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:RIVER CITY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:HARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-456-0170
Mailing Address - Street 1:4342 GALLIA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW BOSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5515
Mailing Address - Country:US
Mailing Address - Phone:740-456-0170
Mailing Address - Fax:740-456-0187
Practice Address - Street 1:4342 GALLIA ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW BOSTON
Practice Address - State:OH
Practice Address - Zip Code:45662-5515
Practice Address - Country:US
Practice Address - Phone:740-456-0170
Practice Address - Fax:740-456-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty