Provider Demographics
NPI:1912289562
Name:ENGEL, DONNA JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:JEAN
Last Name:ENGEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26597 DIXIE HWY
Mailing Address - Street 2:STE 159
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1764
Mailing Address - Country:US
Mailing Address - Phone:419-874-9744
Mailing Address - Fax:
Practice Address - Street 1:26597 DIXIE HWY
Practice Address - Street 2:STE 159
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1764
Practice Address - Country:US
Practice Address - Phone:419-874-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH#9275861OtherGROUP PTAN
OHU55618Medicare UPIN
OHEN0780141Medicare PIN