Provider Demographics
NPI:1437523727
Name:BATAVIA CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BATAVIA CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMERSON
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DIBCN
Authorized Official - Phone:513-515-4937
Mailing Address - Street 1:25 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-2906
Mailing Address - Country:US
Mailing Address - Phone:513-515-4937
Mailing Address - Fax:
Practice Address - Street 1:25 N MARKET ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-2906
Practice Address - Country:US
Practice Address - Phone:513-515-4937
Practice Address - Fax:844-692-7290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH659365OtherOPTUM/UHC
OH1082955OtherASH
OHCS1723300109OtherCARESOURCE
OHQMP000003651293OtherMOLINA
OH2528312Medicaid