Provider Demographics
NPI:1518901883
Name:ROBERT NATHAN FEDORE
Entity Type:Organization
Organization Name:ROBERT NATHAN FEDORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:FEDORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-774-9800
Mailing Address - Street 1:9128 UNION CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2006
Mailing Address - Country:US
Mailing Address - Phone:513-774-9800
Mailing Address - Fax:513-774-9825
Practice Address - Street 1:9128 UNION CEMETERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2006
Practice Address - Country:US
Practice Address - Phone:513-774-9800
Practice Address - Fax:513-774-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty