MEDICARE: NORTH DAYTON GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1043491236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH DAYTON GROUP, LLC

Provider Business Mailing Address
First Line	:	1764 LARELYN LN
Second Line	:
City	:	SHINGLE SPRINGS
State	:	CA
Zip	:	95682-8097
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2517 BURNET AVE
Second Line	:	STE. #200
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2501
Country	:	US
Telephone Number	:	513-221-1200
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GORDON JAMES SPURLING
Credential	:
Telephone Number	:	805-698-5000

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

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