Provider Demographics
NPI:1528160637
Name:JOSEPH A. TARGONSKI
Entity type:Organization
Organization Name:JOSEPH A. TARGONSKI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TARGONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-446-2591
Mailing Address - Street 1:305 EAST LUTZ ROAD
Mailing Address - Street 2:P O BOX 302
Mailing Address - City:ARCHBOLD
Mailing Address - State:OH
Mailing Address - Zip Code:43502
Mailing Address - Country:US
Mailing Address - Phone:419-446-2591
Mailing Address - Fax:419-446-0230
Practice Address - Street 1:305 EAST LUTZ ROAD
Practice Address - Street 2:
Practice Address - City:ARCHBOLD
Practice Address - State:OH
Practice Address - Zip Code:43502
Practice Address - Country:US
Practice Address - Phone:419-446-2591
Practice Address - Fax:419-446-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty