NPI | 1932317666 |
---|---|
Former Legal Business Name | TEAM CHIROPRACTIC, LLC |
Entity Type | Organization |
Authorized Contact | MARY LOU DETTMER Office Manager 317-272-4100 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01017401) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08000607A) |
111NR0200X Chiropractor, Radiology (Licence: IN 08000607A) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: IN 99018585A) | |
Enumeration Date | 2007-05-18 |
Last Update Date | 2008-12-11 |