Basic Information
| Provider Information | |||||||||
| NPI: | 1437620309 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHIROPRACTIC SPECIALISTS OF INDIANA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3961 GOLF BAG LN | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478028145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128874800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 90 EXECUTIVE DR STE E2 | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460322611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7658281003 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2018 | ||||||||
| LastUpdateDate: | 02/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | SNIDER | ||||||||
| AuthorizedOfficialFirstName: | DION | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8128874800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
| NPICertificationDate: | 02/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.