Provider Demographics
NPI:1710968771
Name:LABIG, BLAIR ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:ALAN
Last Name:LABIG
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 1:492 W 2ND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-3698
Mailing Address - Country:US
Mailing Address - Phone:937-376-1234
Mailing Address - Fax:937-376-1443
Practice Address - Street 1:492 W 2ND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-3698
Practice Address - Country:US
Practice Address - Phone:937-376-1234
Practice Address - Fax:937-376-1443
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000020772OtherBLUE CROSS/BLUE SHIELD
OH0318696Medicaid
OH0318696Medicaid
OH000000020772OtherBLUE CROSS/BLUE SHIELD