Provider Demographics
NPI:1174249825
Name:LANGHALS, PHILLIP ALAN
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:ALAN
Last Name:LANGHALS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-2322
Mailing Address - Country:US
Mailing Address - Phone:419-967-0973
Mailing Address - Fax:
Practice Address - Street 1:709 GLENDALE DR
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-2322
Practice Address - Country:US
Practice Address - Phone:419-967-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child