Provider Demographics
NPI:1306731765
Name:SPEICHER, CHAZZ CHARLES
Entity type:Individual
Prefix:
First Name:CHAZZ
Middle Name:CHARLES
Last Name:SPEICHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 MOUNT PLEASANT ST NW
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:44216-9550
Mailing Address - Country:US
Mailing Address - Phone:330-714-4803
Mailing Address - Fax:
Practice Address - Street 1:161 ANNA AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5149
Practice Address - Country:US
Practice Address - Phone:330-936-4314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion