Healthcare Provider Details

I. General information

NPI: 1174520001
Provider Name (Legal Business Name): ANTHONY R BATTAGLIA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

762 S CLEVELAND MASSILLON RD
FAIRLAWN OH
44333-3024
US

IV. Provider business mailing address

762 S CLEVELAND MASSILLON RD
FAIRLAWN OH
44333-3024
US

V. Phone/Fax

Practice location:
  • Phone: 330-665-4100
  • Fax: 330-665-4190
Mailing address:
  • Phone: 330-665-4100
  • Fax: 330-665-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1019
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: