Provider Demographics
NPI:1063780294
Name:CHAFFEE FAMILY CHIRO INC
Entity type:Organization
Organization Name:CHAFFEE FAMILY CHIRO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FLANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-866-7730
Mailing Address - Street 1:5555 COUNTY ROAD 203
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-8291
Mailing Address - Country:US
Mailing Address - Phone:330-893-4440
Mailing Address - Fax:330-893-9335
Practice Address - Street 1:5555 COUNTY ROAD 203
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-8291
Practice Address - Country:US
Practice Address - Phone:330-893-4440
Practice Address - Fax:330-893-9335
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAFFEE CHIROPRACTIC CLINIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-02
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH085630Medicare PIN