=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104714526
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAGEL CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2025
-----------------------------------------------------
Last Update Date | 07/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1234 RIDGEWOOD DR STE D
-----------------------------------------------------
City | BOWLING GREEN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43402-2695
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-352-0914
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1234 RIDGEWOOD DR STE D
-----------------------------------------------------
City | BOWLING GREEN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43402-2695
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-352-0914
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CHIROPRACTOR
-----------------------------------------------------
Name | MS. DANIELLE M RYWALSKI
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 419-352-0914
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------