MEDICARE: DR. JEREMY WARDEN D.C.

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	111NT0100X	Thermography Chiropractor	3336	OH

General Provider Information

NPI Number	:	1710989942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEREMY WARDEN D.C.

Provider Business Mailing Address
First Line	:	6913 S DWYER RD
Second Line	:
City	:	OKEANA
State	:	OH
Zip	:	45053-9409
Country	:	US
Telephone Number	:	513-738-3999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2605 CINCINNATI BROOKVILLE RD
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5905
Country	:	US
Telephone Number	:	513-738-3999
Fax Number	:	513-738-2968

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/08/2007

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