Provider Demographics
NPI:1174520001
Name:BATTAGLIA, ANTHONY R (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:R
Last Name:BATTAGLIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 S CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3024
Mailing Address - Country:US
Mailing Address - Phone:330-665-4100
Mailing Address - Fax:330-665-4190
Practice Address - Street 1:762 S CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3024
Practice Address - Country:US
Practice Address - Phone:330-665-4100
Practice Address - Fax:330-665-4190
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1019111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0926949Medicaid
OH0926949Medicaid