Provider Demographics
NPI:1225006141
Name:BATES, NATALIE LYNN (DC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:LYNN
Last Name:BATES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELIDA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-1043
Mailing Address - Country:US
Mailing Address - Phone:419-339-0500
Mailing Address - Fax:419-339-0800
Practice Address - Street 1:316 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ELIDA
Practice Address - State:OH
Practice Address - Zip Code:45807-1043
Practice Address - Country:US
Practice Address - Phone:419-339-0500
Practice Address - Fax:419-339-0800
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3196111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2269101Medicaid
OHBA4059161Medicare ID - Type Unspecified
OHU86719Medicare UPIN