Provider Demographics
NPI:1144274192
Name:DOSSI, KATIE BROOKE (DC)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:BROOKE
Last Name:DOSSI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:BROOKE
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1761 BEALL AVE
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2342
Mailing Address - Country:US
Mailing Address - Phone:330-263-8763
Mailing Address - Fax:330-263-8190
Practice Address - Street 1:3727 FRIENDSVILLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7131
Practice Address - Country:US
Practice Address - Phone:330-202-2225
Practice Address - Fax:330-202-3410
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4173791Medicaid
OH4173791Medicaid