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NPI Code Detail

MEDICARE: RESTORATION FAMILY CHIROPRACTIC

MEDICARE: RESTORATION FAMILY CHIROPRACTIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1053951137
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORATION FAMILY CHIROPRACTIC
Provider Business Mailing Address
First Line : 6351 BIRDS EYE DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-6171
Country : US
Telephone Number : 574-870-1375
Fax Number :
Provider Business Practice Location Address
First Line : 5915 S EMERSON AVE STE 400
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-1972
Country : US
Telephone Number : 812-200-6204
Fax Number :
Authorized Official
Title or Position : SOLE MEMBER
Name : DR. EMILEAH ANN VAN MATRE
Credential : DC
Telephone Number : 574-870-1375
Provider Enumeration Date : 01/07/2020
Last Update Date : 01/07/2020

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Directions to “RESTORATION FAMILY CHIROPRACTIC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.