| 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 |