is a Chiropractor in Fort Wayne, Indiana. practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for is 1720030984. The last update date is .
's current location address is 7127 Homestead Rd Ste F, Fort Wayne, Indiana. You can contact this provider via phone number 2604328777 and fax number 2604328777. The mailing address for is 7127 Homestead Rd Ste F, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 7127 Homestead Rd Ste F, Fort Wayne, Indiana |
| Phone Number | 2604328777 |
| Fax Number | 2604328777 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1720030984 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 7127 Homestead Rd Ste F |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468144601 |
| Phone Number | 2604328777 |
| Fax Number | 2604328777 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 08000682A |
|
Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 91604 | ANTHEM | ||
| 100253380A | IN | -- |
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