Organization
ACTIVE HEALTHCARE OF NELSONVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ANN HINE (OFFICE MANAGER)
(740) 753-1902
Entity
Organization
Contact information
Practice address
1259 E CANAL ST, NELSONVILLE, OH 45764-8000
(740) 753-1902
(740) 753-4233
Mailing address
1259 E CANAL ST, NELSONVILLE, OH 45764-8000
(740) 753-1902
(740) 753-4233
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2400
OH
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2014886
—
OH
Enumeration date
09/24/2012
Last updated
01/22/2013
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