Provider Demographics
NPI:1972128817
Name:PATRIOT HOLDINGS OF OHIO, LLC
Entity Type:Organization
Organization Name:PATRIOT HOLDINGS OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-398-3611
Mailing Address - Street 1:812 COSHOCTON AVE # 154
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1947
Mailing Address - Country:US
Mailing Address - Phone:740-398-3611
Mailing Address - Fax:
Practice Address - Street 1:3860 HARD RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8025
Practice Address - Country:US
Practice Address - Phone:614-356-7653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRIOT HOLDINGS OF OHIO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty