Provider Demographics
NPI:1578559316
Name:KREGER, JAMES CARL (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CARL
Last Name:KREGER
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 1:7584 KINGS POINTE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1557
Mailing Address - Country:US
Mailing Address - Phone:419-841-4207
Mailing Address - Fax:419-841-4312
Practice Address - Street 1:3231 CENTRAL PARK W
Practice Address - Street 2:SUITE 110
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3008
Practice Address - Country:US
Practice Address - Phone:419-841-4207
Practice Address - Fax:419-841-4312
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH995111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0544943Medicare PIN