Provider Demographics
NPI:1598096125
Name:MOKSA BATTLE, JAMEEL MIKAL (DPT, AT, DIPL OM)
Entity Type:Individual
Prefix:MR
First Name:JAMEEL
Middle Name:MIKAL
Last Name:MOKSA BATTLE
Suffix:
Gender:M
Credentials:DPT, AT, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18337
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45218-0337
Mailing Address - Country:US
Mailing Address - Phone:513-349-4665
Mailing Address - Fax:
Practice Address - Street 1:9403 KENWOOD RD STE B102
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6829
Practice Address - Country:US
Practice Address - Phone:513-349-4665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14547171100000X
OHPT017757225100000X
374U00000X
OH66.000066171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0005429Medicaid
OH0360068Medicaid