| Jack Allen Hendricks, | |
|
1228 Nordica Ln, Cincinnati, OH 45255-3118 | |
| (513) 474-9377 | |
| Not Available |
| Full Name | Jack Allen Hendricks |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 1228 Nordica Ln, Cincinnati, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265116560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 2367 (Ohio) | Primary |
| Provider Name | Clearly Chiropractic Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1861776577 PECOS PAC ID: 7719348689 Enrollment ID: O20230726000271 |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Allen Hendricks, 1228 Nordica Ln, Cincinnati, OH 45255-3118 Ph: (513) 474-9377 | Jack Allen Hendricks, 1228 Nordica Ln, Cincinnati, OH 45255-3118 Ph: (513) 474-9377 |
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