WOODVILLE PROFESSIONAL HEALTHCARE LLC (NPI# 1780866525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780866525 |
Entity Type | Organization |
Organization Name | WOODVILLE PROFESSIONAL HEALTHCARE LLC |
Other Organization Name | FREMONT CHIROPRACTIC CLINIC |
Practice Address |
1823 W State St Fremont OH 43420-1635 |
Practice Telephone | 4193347737 |
Practice Fax Number | 4193342828 |
Mailing Telephone | 4193347737 |
Mailing Fax Number | 4193342828 |
Enumeration Date | 2007-12-04 |
Last Update Date | 2013-08-05 |
Authorized Official Name | DR. TY N TRACY (OWNER) |
Authorized Official Telephone | 4193347737 |
Authorized Official Credential | DC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2805 | OH | Chiropractic Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | ANTHEM BCBS | 000000362532 | 01 |
Other Name | Type Code |
---|---|
Fremont Chiropractic Clinic | Doing Business As Name - Organization |
Street Address |
1823 W STATE ST |
City | FREMONT |
State | OH |
Zip Code | 43420-1635 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114047495 | Jennifer L Costilla | Massage Therapist | 1823 W State St, Fremont, OH 43420-1635 | 2007-03-30 |
1215137567 | Rickey Wright Md LLC | General Practice | 1823 W State St, Fremont, OH 43420-1635 | 2007-07-24 |
1629090956 | Rickey Wright | General Practice | 1823 W State St, Fremont, OH 43420-1635 | 2006-07-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225596570 | Trisha D Hamm | Nurse Practitioner | Walk In Urgent Care, 2180 Sean Dr., #6b, Fremont, OH 43420 | 2019-03-06 |
1558886051 | Kortney Blair Potridge | Homemaker | 1718 Buckland Avenue, Fremont, OH 43420 | 2017-08-07 |
1699134015 | Gentle Caring Dentistry of Fremont Ohio | Dentist | 2430 Enterprise St, Fremont, OH 43420 | 2016-02-12 |
1033574587 | Alyssa Dickman | Physical Therapy Assistant | 1310 Chestnut St, Fremont, OH 43420 | 2015-12-29 |
1437566734 | Michael Allen Koebel | Registered Nurse | 1728 Oak Harbor Rd, Fremont, OH 43420 | 2014-07-18 |
1598183774 | Harry D. Burger | Dentist | 567 Bartson Rd., Fremont, OH 43420 | 2014-04-03 |
1750706636 | Lori Fisher | Registered Nurse | 500 W. State St., Suite A, Fremont, OH 43420 | 2014-02-28 |
1699113001 | Cora Renea Minich | Massage Therapist | 510 Court Street, Fremont, OH 43420 | 2013-06-07 |
1477850071 | Parschauer Eye Center Inc | Eyewear Supplier (Equipment, not the service) | 126 S. Front St, Fremont, OH 43420 | 2011-02-16 |
1316260839 | Marla D Carlisle | Physician Assistant | 605 Third Avenue, Suite B, Fremont, OH 43420 | 2010-03-11 |
Find all providers in zip 43420 |
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 |
---|---|---|---|---|
1811595762 | Haynes Chiropractic | Chiropractor | 3775 Beacon Ave Ste 200, Fremont, CA 94538-1466 | 2020-10-13 |
1720626062 | Kevin A Bruinsma | Chiropractor | 43344 Mission Blvd, Fremont, CA 94539-5829 | 2019-12-17 |
1861950081 | Frank Alexios Lee | Chiropractor | 39420 Liberty St Ste 160, Fremont, CA 94538-2296 | 2019-03-06 |
1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
1982138731 | Christopher Morrow | Chiropractor | 3040 Beard Rd, Fremont, CA 94555-1470 | 2017-04-19 |
1316393754 | Ashley Chen | Chiropractor | 40668 Canyon Heights Dr, Fremont, CA 94539-3886 | 2016-05-04 |
1407155203 | Mohamed Sayed El-shimey | Chiropractor | 3100 Capitol Ave Ste C, Fremont, CA 94538-1527 | 2011-03-18 |
1831497965 | Sino-legacy Acupuncture Clinic | Chiropractor | 46164 Warm Springs Blvd, Unit 266, Fremont, CA 94539-7985 | 2011-03-14 |
1992012678 | Shafiq Ansari | Chiropractor | 200 Brown Rd Ste 112, Fremont, CA 94539-7984 | 2010-09-01 |
1750693610 | Patrick Joseph Walter | Chiropractor | 39355 California St Ste 106, Fremont, CA 94538-1447 | 2010-07-08 |
Find all providers in FREMONT |
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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.