Provider Demographics
NPI:1821173873
Name:HUANG, ROGER SAAK (DC)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:SAAK
Last Name:HUANG
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 1:2709 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-4959
Mailing Address - Country:US
Mailing Address - Phone:440-998-2200
Mailing Address - Fax:440-997-5695
Practice Address - Street 1:2709 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4959
Practice Address - Country:US
Practice Address - Phone:440-998-2200
Practice Address - Fax:440-997-5695
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2274426Medicaid
OH2274426Medicaid