Provider Demographics
NPI:1487245155
Name:LAGARD, BENJAMIN ROSS (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ROSS
Last Name:LAGARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 716
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0716
Mailing Address - Country:US
Mailing Address - Phone:740-775-1900
Mailing Address - Fax:740-775-2070
Practice Address - Street 1:265 N WOODBRIDGE AVE STE B
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2284
Practice Address - Country:US
Practice Address - Phone:740-775-1900
Practice Address - Fax:740-775-2070
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05060111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty