Healthcare Provider Details

I. General information

NPI: 1366506784
Provider Name (Legal Business Name): DAVID M BOOTH D.C. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E STATE RD
NEWCOMERSTOWN OH
43832-9448
US

IV. Provider business mailing address

P.O.BOX 255 1200 E STATE STREET
NEWCOMERSTOWN OH
43832-9448
US

V. Phone/Fax

Practice location:
  • Phone: 740-498-7844
  • Fax: 740-498-7504
Mailing address:
  • Phone: 740-498-7844
  • Fax: 740-498-7504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number934
License Number StateOH

VIII. Authorized Official

Name: DR. DAVID M BOOTH
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 740-498-7844