Provider Demographics
NPI:1942298906
Name:SPIELES, TODD E (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:E
Last Name:SPIELES
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 1:1297 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:ST MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-2406
Mailing Address - Country:US
Mailing Address - Phone:419-394-4313
Mailing Address - Fax:419-394-2364
Practice Address - Street 1:1297 E SPRING ST
Practice Address - Street 2:
Practice Address - City:ST MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-2406
Practice Address - Country:US
Practice Address - Phone:419-394-4313
Practice Address - Fax:419-394-2364
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH64111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0201203Medicaid
0408622Medicare ID - Type Unspecified
OH0201203Medicaid