Provider Demographics
NPI:1386880342
Name:RAGON CHIROPRACTIC HEALTH CENTER, LLC
Entity type:Organization
Organization Name:RAGON CHIROPRACTIC HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:RAGON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-896-2030
Mailing Address - Street 1:3333 MASSILLON RD
Mailing Address - Street 2:#206
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5981
Mailing Address - Country:US
Mailing Address - Phone:330-896-2030
Mailing Address - Fax:330-899-0527
Practice Address - Street 1:3333 MASSILLON RD
Practice Address - Street 2:#206
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5981
Practice Address - Country:US
Practice Address - Phone:330-896-2030
Practice Address - Fax:330-899-0527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2915368Medicaid
OH2915368Medicaid
RA4177791Medicare PIN