MEDICARE: MR. JAMEEL MIKAL MOKSA BATTLE DPT, AT, DIPL. O.M.

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	171100000X	Acupuncturist	66.000066	OH
2	2255A2300X	Athletic Trainer
3	374U00000X	Home Health Aide
4	225100000X	Physical Therapist	PT017757	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1598096125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMEEL MIKAL MOKSA BATTLE DPT, AT, DIPL. O.M.

Provider Business Mailing Address
First Line	:	PO BOX 18337
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45218-0337
Country	:	US
Telephone Number	:	513-349-4665
Fax Number	:	513-488-0523

Provider Business Practice Location Address
First Line	:	4010 EXECUTIVE PARK DR STE 135
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-4013
Country	:	US
Telephone Number	:	513-742-2669
Fax Number	:	513-488-0523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	01/06/2025

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