Healthcare Provider Details

I. General information

NPI: 1659350486
Provider Name (Legal Business Name): DOUGLAS J SPIELES DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

496 N MAIN ST
MINSTER OH
45865-9537
US

IV. Provider business mailing address

129 S LINCOLN ST
MINSTER OH
45865-1240
US

V. Phone/Fax

Practice location:
  • Phone: 419-628-2718
  • Fax: 419-628-3850
Mailing address:
  • Phone: 419-628-3117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1417
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: