Provider Demographics
NPI:1992992374
Name:SPIELES CHIROPRACTIC CLINIC INC.
Entity type:Organization
Organization Name:SPIELES CHIROPRACTIC CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPIELES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-628-2718
Mailing Address - Street 1:496 N MAIN ST
Mailing Address - Street 2:PO BOX 112
Mailing Address - City:MINSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45865-9537
Mailing Address - Country:US
Mailing Address - Phone:419-628-2718
Mailing Address - Fax:419-628-3850
Practice Address - Street 1:496 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865-9537
Practice Address - Country:US
Practice Address - Phone:419-628-2718
Practice Address - Fax:419-628-3850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9243541Medicare UPIN