Healthcare Provider Details

I. General information

NPI: 1750386884
Provider Name (Legal Business Name): RONALD RAY WEISEL II D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date: 03/18/2006
Reactivation Date: 03/27/2006

III. Provider practice location address

800 W MAPLE ST STE B
HARTVILLE OH
44632-9682
US

IV. Provider business mailing address

800 W MAPLE ST STE B
HARTVILLE OH
44632-9682
US

V. Phone/Fax

Practice location:
  • Phone: 330-877-3177
  • Fax: 330-877-3525
Mailing address:
  • Phone: 330-877-3177
  • Fax: 330-877-3525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1479
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: