Provider Demographics
NPI:1134636210
Name:PUTHOFF, DEAN WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:WILLIAM
Last Name:PUTHOFF
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 1:1517 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2205
Mailing Address - Country:US
Mailing Address - Phone:419-222-4000
Mailing Address - Fax:419-222-1967
Practice Address - Street 1:1517 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2205
Practice Address - Country:US
Practice Address - Phone:419-222-4000
Practice Address - Fax:419-222-1967
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-04731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor