Provider Demographics
NPI:1124016373
Name:VAN ARSDEL, GINA L (DC)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:L
Last Name:VAN ARSDEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E FOREST ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1212
Mailing Address - Country:US
Mailing Address - Phone:419-584-2225
Mailing Address - Fax:419-584-1876
Practice Address - Street 1:125 E FOREST ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1212
Practice Address - Country:US
Practice Address - Phone:419-584-2225
Practice Address - Fax:419-584-1876
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3374111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2385299Medicaid
4101081Medicare ID - Type Unspecified
OH2385299Medicaid