Provider Demographics
NPI:1639151269
Name:PANAGOPOULOS, CHRIS (DC)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:PANAGOPOULOS
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 1:540 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1541
Mailing Address - Country:US
Mailing Address - Phone:330-533-3351
Mailing Address - Fax:330-533-8966
Practice Address - Street 1:540 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1541
Practice Address - Country:US
Practice Address - Phone:330-533-3351
Practice Address - Fax:330-533-8966
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2153977Medicare ID - Type Unspecified
OHU78164Medicare UPIN
OH0896361Medicare ID - Type Unspecified