MEDICARE: FAMILY CHIROPRACTIC CENTER OF BELLEFONTAINE LLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1548902448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHIROPRACTIC CENTER OF BELLEFONTAINE LLC

Provider Business Mailing Address
First Line	:	412 E COLUMBUS AVE
Second Line	:
City	:	BELLEFONTAINE
State	:	OH
Zip	:	43311-2004
Country	:	US
Telephone Number	:	419-302-2412
Fax Number	:	937-688-3534

Provider Business Practice Location Address
First Line	:	412 E COLUMBUS AVE
Second Line	:
City	:	BELLEFONTAINE
State	:	OH
Zip	:	43311-2004
Country	:	US
Telephone Number	:	419-302-2412
Fax Number	:	937-688-3534

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SCOTT C KAYATIN
Credential	:	DC
Telephone Number	:	937-593-7711

Provider Enumeration Date	:	04/11/2022
Last Update Date	:	01/25/2023

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