| Organization Name: | WATERVILLE CHIROPRACTIC CLINIC LLC |
| NPI Number: | 1194057885 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JON W SCHWANZ (MANAGER) |
| Mailing Address: | 216 South St Waterville |
| State: | OH US |
| Postal Code: | 435661463 |
| Phone Number: | 4198788142 |
| Fax Number: | |
| NPI Enumeration Date: | 02/04/2010 |
| NPI Last Update Date: | 02/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111NT0100X |
| License Number: | 1201 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | Thermography |
| Taxonomy Definition: | |