Provider Demographics
NPI:1346323565
Name:VARGO, RONALD JULIUS (DC, DACRB, CSCS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JULIUS
Last Name:VARGO
Suffix:
Gender:M
Credentials:DC, DACRB, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 WHIPPLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1514
Mailing Address - Country:US
Mailing Address - Phone:330-478-2255
Mailing Address - Fax:330-478-0505
Practice Address - Street 1:2424 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1514
Practice Address - Country:US
Practice Address - Phone:330-478-2255
Practice Address - Fax:330-478-0505
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000352079OtherANTHEM PIN NUMBER
OH000000352079OtherANTHEM PIN NUMBER
OHU61668Medicare UPIN