1386776680 NPI number — BAKER FAMILY CHIROPRACTIC & SPORTS INJURY CLINIC INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386776680 NPI number — BAKER FAMILY CHIROPRACTIC & SPORTS INJURY CLINIC INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAKER FAMILY CHIROPRACTIC & SPORTS INJURY CLINIC INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386776680
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4781 RED BANK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-561-2273
Provider Business Mailing Address Fax Number:
513-561-3571

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7554 VOICE OF AMERICA CENTRE DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST CHESTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-759-4666
Provider Business Practice Location Address Fax Number:
513-561-3571
Provider Enumeration Date:
03/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
513-561-0656

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1888 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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