MEDICARE: QUINNTON PRICE HAISLOP DC

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	DC-05392	OH

General Provider Information

NPI Number	:	1982425484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUINNTON PRICE HAISLOP DC

Provider Business Mailing Address
First Line	:	1252 WELSFORD CT
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-8702
Country	:	US
Telephone Number	:	740-577-1412
Fax Number	:

Provider Business Practice Location Address
First Line	:	1504 YANKEE PARK PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-1878
Country	:	US
Telephone Number	:	937-424-3068
Fax Number	:

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

Provider Enumeration Date	:	10/18/2024
Last Update Date	:	10/18/2024

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Directions to “ QUINNTON PRICE HAISLOP DC” Practice Location

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