MEDICARE: JEFF K. BIRD, 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	3198	OH

General Provider Information

NPI Number	:	1841424645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFF K. BIRD, LLC

Provider Business Mailing Address
First Line	:	7310 YANKEE RD
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9168
Country	:	US
Telephone Number	:	513-777-4244
Fax Number	:	513-777-7760

Provider Business Practice Location Address
First Line	:	7310 YANKEE RD
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9168
Country	:	US
Telephone Number	:	513-777-4244
Fax Number	:	513-777-7760

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY K. BIRD
Credential	:	D.C.
Telephone Number	:	513-777-4244

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	10/20/2009

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