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General NPI Number Information
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NPI Number | 1427265040
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Entity Type | Organization
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Legal Business Name | OTTAWA CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 12/20/2019
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Provider Practice Location Address
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Address Line | 139 S WALNUT ST
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City | OTTAWA
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State | OH
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Zip | 45875-1817
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Country | US
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Telephone | 419-523-5737
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Fax | 419-523-3839
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Provider Business Mailing Address
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Address Line | 139 S WALNUT ST
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City | OTTAWA
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State | OH
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Zip | 45875-1817
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Country | US
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Telephone | 419-523-5737
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Fax | 419-523-3839
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL JAY RAYE
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Credential | D.C.
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Telephone | 419-523-5737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 505
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License Number State | OH
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