Provider Demographics
NPI:1104024892
Name:BESECKER, DAVID L (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:BESECKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 N MIAMI ST
Mailing Address - Street 2:
Mailing Address - City:WEST MILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45383-1830
Mailing Address - Country:US
Mailing Address - Phone:937-314-4180
Mailing Address - Fax:937-339-2440
Practice Address - Street 1:22 N MIAMI ST
Practice Address - Street 2:
Practice Address - City:WEST MILTON
Practice Address - State:OH
Practice Address - Zip Code:45383-1830
Practice Address - Country:US
Practice Address - Phone:937-314-4180
Practice Address - Fax:937-999-6141
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2758421Medicaid
OH2758421Medicaid