Provider Demographics
NPI:1447464862
Name:TWIN CITY CHIROPRACTIC HEALTH & WELLNESS INC..
Entity type:Organization
Organization Name:TWIN CITY CHIROPRACTIC HEALTH & WELLNESS INC..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:WORST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-922-2325
Mailing Address - Street 1:205 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:DENNISON
Mailing Address - State:OH
Mailing Address - Zip Code:44621-1215
Mailing Address - Country:US
Mailing Address - Phone:740-922-2325
Mailing Address - Fax:740-922-9362
Practice Address - Street 1:205 GRANT ST
Practice Address - Street 2:
Practice Address - City:DENNISON
Practice Address - State:OH
Practice Address - Zip Code:44621-1215
Practice Address - Country:US
Practice Address - Phone:740-922-2325
Practice Address - Fax:740-922-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2278262Medicaid
OHAN9319411Medicare ID - Type UnspecifiedGROUP NUMBER
OHWO4032162Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
OH2278262Medicaid