Healthcare Provider Details

I. General information

NPI: 1568550507
Provider Name (Legal Business Name): ANDREW J LIMLE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 HARRISON AVE
CINCINNATI OH
45211-4639
US

IV. Provider business mailing address

4021 HARRISON AVE
CINCINNATI OH
45211-4639
US

V. Phone/Fax

Practice location:
  • Phone: 513-661-6666
  • Fax: 513-661-6665
Mailing address:
  • Phone: 513-661-6666
  • Fax: 513-661-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number3386
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4811
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: