Provider Demographics
NPI:1134318017
Name:GOTTSCHLING CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:GOTTSCHLING CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOTTSCHLING
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:419-756-0701
Mailing Address - Street 1:605 S TRIMBLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4112
Mailing Address - Country:US
Mailing Address - Phone:419-756-2986
Mailing Address - Fax:515-583-6974
Practice Address - Street 1:605 S TRIMBLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4112
Practice Address - Country:US
Practice Address - Phone:419-756-2986
Practice Address - Fax:515-583-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH44-00307OtherUNITED HEALTH CARE
OH0679556Medicaid
OH268600743-00OtherBWC
OH000000194874OtherUNISON
OH000000139658OtherANTHEM
OH10284803700OtherCARESOURCE
OH0679556Medicaid
OH=========003OtherMEDICAL MUTUAL
OHT48627Medicare UPIN