Healthcare Provider Details

I. General information

NPI: 1881007722
Provider Name (Legal Business Name): CHIROMED PLUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 E MARKET ST STE 102
CRAWFORDSVILLE IN
47933-1852
US

IV. Provider business mailing address

407 E MARKET ST STE 102
CRAWFORDSVILLE IN
47933-1852
US

V. Phone/Fax

Practice location:
  • Phone: 765-362-1500
  • Fax: 765-361-8919
Mailing address:
  • Phone: 765-362-1500
  • Fax: 765-361-8919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY R. MCINTYRE
Title or Position: OWNER
Credential: D.C.
Phone: 765-362-1500