Provider Demographics
NPI:1407396880
Name:NOGOSEK, ANTHONY CLA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CLA
Last Name:NOGOSEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 WESTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ARCHBOLD
Mailing Address - State:OH
Mailing Address - Zip Code:43502-1047
Mailing Address - Country:US
Mailing Address - Phone:419-445-1600
Mailing Address - Fax:419-445-1605
Practice Address - Street 1:202 WESTFIELD DR
Practice Address - Street 2:
Practice Address - City:ARCHBOLD
Practice Address - State:OH
Practice Address - Zip Code:43502-1047
Practice Address - Country:US
Practice Address - Phone:419-445-1600
Practice Address - Fax:419-445-1605
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC.4699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor