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NPI Code Detail

MEDICARE: BUBBLEBOY ENTERPRISES LTD

MEDICARE: BUBBLEBOY ENTERPRISES LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2472OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043371248
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUBBLEBOY ENTERPRISES LTD
Provider Business Mailing Address
First Line : 434 W UNION ST
Second Line :
City : ATHENS
State : OH
Zip : 45701-2336
Country : US
Telephone Number : 740-589-2000
Fax Number : 740-589-2002
Provider Business Practice Location Address
First Line : 434 W UNION ST
Second Line :
City : ATHENS
State : OH
Zip : 45701-2336
Country : US
Telephone Number : 740-589-2000
Fax Number : 740-589-2002
Authorized Official
Title or Position : PRESIDENT
Name : DR. DREW RICHARD WILLIAMS
Credential : D.C.
Telephone Number : 740-589-2000
Provider Enumeration Date : 12/12/2006
Last Update Date : 04/13/2015

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Directions to “BUBBLEBOY ENTERPRISES LTD ” Practice Location

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