Provider Demographics
NPI:1992046783
Name:VOGELGESANG FAMILY CHIROPRACTIC, INC
Entity type:Organization
Organization Name:VOGELGESANG FAMILY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:DECKER
Authorized Official - Last Name:VOGELGESANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-818-1212
Mailing Address - Street 1:7266 PORTAGE ST NW
Mailing Address - Street 2:SUITE C
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-7826
Mailing Address - Country:US
Mailing Address - Phone:330-818-1212
Mailing Address - Fax:330-818-1215
Practice Address - Street 1:7266 PORTAGE ST NW
Practice Address - Street 2:SUITE C
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-7826
Practice Address - Country:US
Practice Address - Phone:330-818-1212
Practice Address - Fax:330-818-1215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty