# DR. TY DAHODWALA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1760410336
- **Gender:** Man
- **Credential:** D.C.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3000 | OH | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000228478 | ANTHEM BCBS PROVIDER ID | OH |
| 01 | — | 104952 | KAISER ID | OH |
| 05 | — | 2319075 | — | OH |
| 01 | — | F03000 | APEX PROVIDER ID | OH |