Provider Demographics
NPI:1861401325
Name:WESTWOOD CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:WESTWOOD CHIROPRACTIC CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-481-6333
Mailing Address - Street 1:3247 MCHENRY AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-7533
Mailing Address - Country:US
Mailing Address - Phone:513-481-6333
Mailing Address - Fax:513-481-6440
Practice Address - Street 1:3247 MCHENRY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-7533
Practice Address - Country:US
Practice Address - Phone:513-481-6333
Practice Address - Fax:513-481-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000018806OtherBC/BS
OH0119348Medicaid
OH=========026OtherCARESOURCE
OH0119348Medicaid