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General NPI Number Information
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NPI Number | 1073841177
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Entity Type | Organization
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Legal Business Name | FLAG CITY SPORT AND SPINE LLC
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 12/01/2009
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Provider Practice Location Address
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Address Line | 643 TRENTON AVE
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City | FINDLAY
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State | OH
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Zip | 45840-2640
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Country | US
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Telephone | 419-427-6300
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Fax | 419-427-2588
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Provider Business Mailing Address
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Address Line | 643 TRENTON AVE
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City | FINDLAY
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State | OH
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Zip | 45840-2640
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Country | US
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Telephone | 419-427-6300
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Fax | 419-427-2588
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. CHRISTOPHER A LOFQUIST
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Credential | DC
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Telephone | 419-360-0262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4019
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License Number State | OH
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