Provider Demographics
NPI:1649596412
Name:BELDEN VILLAGE CHIROPRACTIC & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:BELDEN VILLAGE CHIROPRACTIC & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE/BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOERSCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-493-0009
Mailing Address - Street 1:4200 MUNSON ST NW STE B
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2981
Mailing Address - Country:US
Mailing Address - Phone:330-493-0009
Mailing Address - Fax:330-493-6659
Practice Address - Street 1:4200 MUNSON ST NW STE B
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2981
Practice Address - Country:US
Practice Address - Phone:330-493-0009
Practice Address - Fax:330-493-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0694244Medicaid
OH9387871Medicare UPIN