CHIROPRACTIC 419 LLC (NPI# 1255684684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255684684 |
| Entity Type | Organization |
| Organization Name | CHIROPRACTIC 419 LLC |
| Other Organization Name | HEALTHSOURCE CHIROPRACTIC SOUTH TOLEDO |
| Practice Address |
4400 Heatherdowns Blvd Suite 5a Toledo OH 43614-3147 |
| Practice Telephone | 4197201472 |
| Mailing Telephone | 4197201472 |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | DR. SHAWN BROHL (CHIROPRACTOR) |
| Authorized Official Telephone | 4197201472 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2089 | OH | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| HealthSource Chiropractic South Toledo | Doing Business As Name - Organization |
| Street Address |
4400 HEATHERDOWNS BLVD SUITE 5A |
| City | TOLEDO |
| State | OH |
| Zip Code | 43614-3147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952586075 | Health Source of Warren, Inc. | Clinic/Center | 4400 Heatherdowns Blvd, Toledo, OH 43614-3147 | 2008-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339168 | Chao Chun George Chang | Student in an Organized Health Care Education/Training Program | 3000 Arlington Ave. Mail Stop 1068, Department of Pathology, Toledo, OH 43614 | 2020-09-07 |
| 1902417926 | Heather Louise Perne | Nurse Practitioner | The University of Toledo Medical Center, 3000 Arlington Ave, Toledo, OH 43614 | 2020-08-13 |
| 1750910188 | Joseph Nabil Said Kamel | Student in an Organized Health Care Education/Training Program | 3120 Glendale Ave Ste L, Toledo, OH 43614 | 2020-04-07 |
| 1386290302 | Concertohealth of Ohio LLC | Family Medicine | 5553 Southwyck Boulevard, Suite 101, Toledo, OH 43614 | 2019-08-15 |
| 1154983120 | Yong Woo Jeon | Student in an Organized Health Care Education/Training Program | 3000 Arlington Ave, Mailstop 1132, Toledo, OH 43614 | 2019-06-30 |
| 1093372096 | Anwer Aldhaheri | Student in an Organized Health Care Education/Training Program | 3000 Arlington Ave, Ms 1095, Dowling Hall, Room 2153a, Toledo, OH 43614 | 2019-05-24 |
| 1073090205 | Syed Fahmeed Imam | Student in an Organized Health Care Education/Training Program | Ruppert Health Center, 3125 Transvers Dr, Toledo, OH 43614 | 2018-07-20 |
| 1861988875 | Sandeep Randhawa | Pediatrics | Rupert Health Centre, Utmc Campus, 3125, Transverse Drive, Toledo, OH 43614 | 2018-07-03 |
| 1861985251 | Khin Sie | Family Medicine | Rocket Pediatrics, Ruppert Health Center, 3125 Transverse Drive., Toledo, OH 43614 | 2018-06-11 |
| 1548765126 | Alex Lu | Emergency Medicine | 3000 Arlington Ave., Mailstop 1088, 2456 Dowling Hall, Toledo, OH 43614 | 2018-03-27 |
| Find all providers in zip 43614 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568089779 | Harry John Dermanelian II | Chiropractor | 3504 Secor Rd Ste 325, Toledo, OH 43606-1545 | 2020-07-03 |
| 1740772888 | Anthony Dumas | Chiropractor | 723 Phillips Ave Bldg C, Toledo, OH 43612-1351 | 2018-06-05 |
| 1467950212 | Inner Health Chiropractic North, LLC | Chiropractor | 3450 West Central Ave, Suite 136, Inner Health Chiropractic, Toledo, OH 43606 | 2018-01-26 |
| 1992245880 | Kevin Tackett | Chiropractor | 4165 Monroe St Ste A, Toledo, OH 43606-2038 | 2017-02-27 |
| 1497207658 | Body Resort, LLC | Chiropractor | 1616 Lawrence Ave Ste B, Toledo, OH 43607-2068 | 2016-11-03 |
| 1689128068 | Hampton Chiropractic, LLC | Chiropractor | 4253 Monroe St, Toledo, OH 43606-1943 | 2016-08-15 |
| 1538613385 | Marcel Hampton | Chiropractor | 1616 Lawrence Ave Ste Ab, Toledo, OH 43607-2067 | 2016-08-10 |
| 1932567526 | Marissa L Fields | Chiropractor | 44005 Talmadge Road, Toledo, OH 43623-3506 | 2016-02-10 |
| 1659782563 | Fallen Timber Spine & Rehab LLC | Chiropractor | 3130 W Central Ave Unit 23, Toledo, OH 43606-2959 | 2014-05-13 |
| 1386075414 | Toledo Holistic Healthcare LLC | Chiropractor | 2828 W Central Ave, Suite 1, Toledo, OH 43606-3078 | 2013-11-27 |
| Find all providers in TOLEDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.