Healthcare Provider Details

I. General information

NPI: 1366231615
Provider Name (Legal Business Name): FORTITUDE SPINE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 MERRILLVILLE RD STE 9
CROWN POINT IN
46307-2710
US

IV. Provider business mailing address

8520 ALLISON POINTE BLVD STE 223
INDIANAPOLIS IN
46250-4299
US

V. Phone/Fax

Practice location:
  • Phone: 800-631-9275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLAS RYAN EVENHOUSE
Title or Position: PRESIDENT
Credential: DC
Phone: 800-631-9275