MEDICARE: DOOLEY CHIROPRACTIC 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	261QH0100X	Health Service Clinic/Center	4010	OH

General Provider Information

NPI Number	:	1588998132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOOLEY CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	3060 DAYTON XENIA RD
Second Line	:	SUITE A
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434-6308
Country	:	US
Telephone Number	:	937-427-2225
Fax Number	:	937-431-1722

Provider Business Practice Location Address
First Line	:	3060 DAYTON XENIA RD
Second Line	:	SUITE A
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434-6308
Country	:	US
Telephone Number	:	937-427-2225
Fax Number	:	937-431-1722

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIMOTHY DAVID DOOLEY
Credential	:	D.C.
Telephone Number	:	937-427-2225

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	09/30/2009

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