# DUBLIN ACTIVE SPINE & REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609428986
- **Authorized official:** MICHAEL GUSTAFSON DC (OWNER)
- **Authorized official phone:** (614) 766-2424

## Contact information

- **Practice address:** 6075 GLICK RD, POWELL, OH 43065-8390
- **Practice address phone:** (614) 766-2424
- **Practice address fax:** (740) 522-6308
- **Mailing address:** 6075 GLICK RD, POWELL, OH 43065-8390
- **Mailing address phone:** (614) 766-2424
- **Mailing address fax:** (740) 522-6308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2019
- **Last updated:** 07/31/2019