COUNTRYSIDE CLINIC OF CHIROPRACTIC, LLC
NPI 1063837367
Chiropractor in Lebanon, OH

Q: What is Countryside Clinic Of Chiropractic, LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since February 23, 2014

990 BELVEDERE DR STE B, LEBANON, OH 45036(513) 836-8844(513) 836-8845 Get Directions Write a Review

NPPES record last updated: November 26, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 26, 2019, Sep 3, 2019 (2 updates tracked since 2019).

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About Countryside Clinic Of Chiropractic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRYSIDE CLINIC OF CHIROPRACTIC, LLC (NPI 1063837367) is a healthcare organization registered as a chiropractor in Lebanon, Ohio and active in the NPI registry since February 2014. The organization lists Tony Dejtiranukul, Owner, as its authorized official.

NPPES Registry Identity

NPI1063837367

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameCOUNTRYSIDE CLINIC OF CHIROPRACTIC, LLC

Location Address990 BELVEDERE DR STE BLebanon, OH 45036-1193

Mailing Address990 Belvedere Dr Ste BLebanon, OH 45036-1193 · (513) 836-8844 · Fax (513) 836-8845

Phone(513) 836-8844

Fax(513) 836-8845

Organization SubpartNo

Authorized OfficialTony DejtiranukulOwner · (314) 496-6030

Enumeration DateFebruary 23, 2014

Last NPPES UpdateNovember 26, 20192 updates tracked since enumeration

✔ NPI 1063837367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in OH · 4008

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

990 BELVEDERE DR STE B, Lebanon, OH 45036

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TONY DEJTIRANUKUL D.C.

Chiropractor

990 BELVEDERE DR STE B
LEBANON, OH 45036

Warren County (513) 836-8844

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Countryside Clinic Of Chiropractic, LLC's NPI number?

The NPI number for Countryside Clinic Of Chiropractic, LLC is 1063837367. It was assigned to this organization in the NPPES registry on February 23, 2014.

Where is Countryside Clinic Of Chiropractic, LLC located?

Countryside Clinic Of Chiropractic, LLC is located at 990 Belvedere Dr Ste B, Lebanon, OH 45036. The listed phone number is (513) 836-8844.

What is Countryside Clinic Of Chiropractic, LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Countryside Clinic Of Chiropractic, LLC was last updated on November 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.