Provider Demographics
NPI:1467864439
Name:DR LOUIS VALENTINE
Entity Type:Organization
Organization Name:DR LOUIS VALENTINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-291-4800
Mailing Address - Street 1:7450 S MASON MONTGOMERY RD
Mailing Address - Street 2:208
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7450 S MASON MONTGOMERY RD
Practice Address - Street 2:208
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7802
Practice Address - Country:US
Practice Address - Phone:513-791-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC.2703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4037362Medicare UPIN