MEDICARE: CHIROPRACTIC PRODUCTS, INC.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000246820	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1922213842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC PRODUCTS, INC.

Provider Business Mailing Address
First Line	:	10620 CORPORATE DR STE D
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1711
Country	:	US
Telephone Number	:	260-496-8555
Fax Number	:	260-496-8488

Provider Business Practice Location Address
First Line	:	10620 CORPORATE DR STE D
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1711
Country	:	US
Telephone Number	:	260-496-8555
Fax Number	:	260-496-8488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS ELIZABETH A ALDAPE
Credential	:	D.C.
Telephone Number	:	260-496-8555

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/22/2020

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Directions to “CHIROPRACTIC PRODUCTS, INC. ” Practice Location

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