Provider Demographics
NPI:1780961789
Name:EAGY, CHAD (DC)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:EAGY
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 1:180 W OLENTANGY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8715
Mailing Address - Country:US
Mailing Address - Phone:567-204-1218
Mailing Address - Fax:
Practice Address - Street 1:180 W OLENTANGY ST
Practice Address - Street 2:SUITE A
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8715
Practice Address - Country:US
Practice Address - Phone:567-204-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4167111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor