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General NPI Number Information
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NPI Number | 1598104879
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Entity Type | Organization
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Legal Business Name | SCIENCE BASED NUTRITION INC
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 5777 FAR HILLS AVE
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City | DAYTON
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State | OH
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Zip | 45429-2207
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Country | US
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Telephone | 937-433-3241
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Fax | 937-496-5468
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Provider Business Mailing Address
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Address Line | 5777 FAR HILLS AVE
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City | DAYTON
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State | OH
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Zip | 45429-2207
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Country | US
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Telephone | 937-433-3241
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Fax | 937-496-5468
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VAN D MERKLE
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Credential | D.C., D.A.B.C.I.,
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Telephone | 937-433-3241
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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 | 973
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License Number State | OH
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