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General NPI Number Information
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NPI Number | 1952777039
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PHYSICAL MEDICINE OF DAYTON
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Dates
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Enumeration Date | 08/12/2015
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 1504 YANKEE PARK PL
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City | CENTERVILLE
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State | OH
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Zip | 45458-1878
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Country | US
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Telephone | 937-424-3068
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 YANKEE PARK PL
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City | CENTERVILLE
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State | OH
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Zip | 45458-1878
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Country | US
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Telephone | 937-424-3068
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIM DOOLEY
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Credential | DC
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Telephone | 937-424-3068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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