Provider Demographics
NPI:1255361747
Name:GAINAN, PHIL M (DC)
Entity type:Individual
Prefix:DR
First Name:PHIL
Middle Name:M
Last Name:GAINAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:6960 MARKET ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4508
Mailing Address - Country:US
Mailing Address - Phone:330-629-9476
Mailing Address - Fax:330-628-2024
Practice Address - Street 1:6960 MARKET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4508
Practice Address - Country:US
Practice Address - Phone:330-629-9476
Practice Address - Fax:330-628-2024
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH2928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000116209OtherANTHEM BCBS
341944535OtherCIGNA
341944535OtherENTERPRISE GROUP
0007829077OtherAETNA
341944535OtherCHIRO HEALTH
341944535OtherCEBA CLAIMS
341944535OtherBENEFITS
341944535OtherEMERALD HEALTH
341944535OtherACN
341944535OtherAFLEC
341944535OtherAPWU
3419944535OtherCONSTITUTION STATE SERV
341944535OtherCHIRO HEALTH