Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC27371 | CA |
Y | 111NR0400X | Rehabilitation Chiropractor | CHIR008251 | GA |
NPI | 1265508931 |
---|---|
Provider Name | Dr. Ronald William Vargo |
First Address | Fayetteville, GA 30214-3999 |
Second Address | Fayetteville, GA 30214-3999 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 18/11/2009 |