Alexa Nicole Bodine, DC
Individual provider Active NPI Chiropractor · Poland, OH
NPI 1558074690 · NPPES record last updated Jan 4, 2023
Key facts
- NPI
- 1558074690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC-05218 (OH)
- Practice address
- 44 N Main St
Poland, OH 44514-1627 - Phone
- (330) 757-4029
- NPI assigned
- Jan 4, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC-05218 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poland Chiropractic Clinic Inc | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC-05218 | OH | Yes |
Addresses
Primary practice location
44 N Main St
Poland, OH 44514-1627
Mailing address
44 N Main St
Poland, OH 44514-1627
Other providers in Poland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.