Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 254 | OH |
NPI | 1386642809 |
---|---|
Provider Name | John Dwight Bashline |
First Address | Flushing, OH 43977-9733 |
Second Address | Flushing, OH 43977-9733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0432633 | (05) | OH |
0984019 | UMWA MEDICARE FUNDS (01) | OH |
T46345 | (02) | OH |