Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Countryside Clinic of Chiropractic, LLC

Organization Chiropractor · NPI 1063837367

Countryside Clinic of Chiropractic, LLC is a Chiropractor in Lebanon, Ohio. Licensed in Ohio. Registered with an NPI since 2014.

Licensed in
OH
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

990 Belvedere Dr Ste B
Lebanon, OH 45036-1193
Phone: (513) 836-8844
Fax: (513) 836-8845
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence 4008 (OH)

Record details

NPI number1063837367
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tony Dejtiranukul — Owner · (314) 496-6030
NPI enumeratedFebruary 23, 2014
Last updated in NPPESNovember 26, 2019
Mailing address990 Belvedere Dr Ste B, Lebanon, OH 45036-1193

Other providers in Lebanon