Provider Demographics
NPI:1255511333
Name:JAMES C. KREGER, D.C. LLC
Entity type:Organization
Organization Name:JAMES C. KREGER, D.C. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:KREGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-841-4207
Mailing Address - Street 1:3231 CENTRAL PARK W
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-3008
Mailing Address - Country:US
Mailing Address - Phone:419-841-4207
Mailing Address - Fax:419-841-4312
Practice Address - Street 1:3231 CENTRAL PARK W
Practice Address - Street 2:SUITE 110
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3008
Practice Address - Country:US
Practice Address - Phone:419-841-4207
Practice Address - Fax:419-841-4312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH995111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9359691Medicare PIN