Healthcare Provider Details
I. General information
NPI: 1598096125
Provider Name (Legal Business Name): JAMEEL MIKAL MOKSA BATTLE DPT, AT, DIPL. O.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/21/2010
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4010 EXECUTIVE PARK DR STE 135
CINCINNATI OH
45241-4013
US
IV. Provider business mailing address
PO BOX 18337
CINCINNATI OH
45218-0337
US
V. Phone/Fax
- Phone: 513-742-2669
- Fax: 513-488-0523
- Phone: 513-349-4665
- Fax: 513-488-0523
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 66.000066 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2255A2300X |
| Taxonomy | Athletic Trainer |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT017757 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: