Provider Demographics
NPI:1073841177
Name:FLAG CITY SPORT AND SPINE LLC
Entity Type:Organization
Organization Name:FLAG CITY SPORT AND SPINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOFQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-360-0262
Mailing Address - Street 1:643 TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-2640
Mailing Address - Country:US
Mailing Address - Phone:419-427-6300
Mailing Address - Fax:419-427-2588
Practice Address - Street 1:643 TRENTON AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-2640
Practice Address - Country:US
Practice Address - Phone:419-427-6300
Practice Address - Fax:419-427-2588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty