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General NPI Number Information
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NPI Number | 1447786090
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Entity Type | Organization
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Legal Business Name | DR W NATHAN BAXTER INC
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Dates
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Enumeration Date | 05/02/2017
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Last Update Date | 09/14/2017
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Provider Practice Location Address
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Address Line | 5812 WILMINGTON PIKE
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City | CENTERVILLE
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State | OH
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Zip | 45459-7004
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Country | US
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Telephone | 937-886-7474
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Fax | 937-886-7475
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Provider Business Mailing Address
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Address Line | 5812 WILMINGTON PIKE
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City | CENTERVILLE
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State | OH
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Zip | 45459-7004
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Country | US
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Telephone | 937-886-7474
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Fax | 937-886-7475
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM NATHANIEL BAXTER
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Credential | D.C.
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Telephone | 816-419-9883
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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 | DC4070
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License Number State | OH
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