Provider Demographics
NPI:1710989942
Name:WARDEN, JEREMY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:
Last Name:WARDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6913 S DWYER RD
Mailing Address - Street 2:
Mailing Address - City:OKEANA
Mailing Address - State:OH
Mailing Address - Zip Code:45053-9409
Mailing Address - Country:US
Mailing Address - Phone:513-738-3999
Mailing Address - Fax:
Practice Address - Street 1:2605 CINCINNATI BROOKVILLE RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5905
Practice Address - Country:US
Practice Address - Phone:513-738-3999
Practice Address - Fax:513-738-2968
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3336111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NT0100XChiropractic ProvidersChiropractorThermography