Healthcare Provider Details

I. General information

NPI: 1255587267
Provider Name (Legal Business Name): ABOUT LIFE CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2008
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9845 E 116TH ST STE 300
FISHERS IN
46037-9236
US

IV. Provider business mailing address

9845 E 116TH ST STE 300
FISHERS IN
46037-9236
US

V. Phone/Fax

Practice location:
  • Phone: 317-913-1812
  • Fax: 317-913-1768
Mailing address:
  • Phone: 317-913-1812
  • Fax: 317-913-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002016A
License Number StateIN

VIII. Authorized Official

Name: JULIE CARLETON
Title or Position: PRESIDENT
Credential: D.C.
Phone: 317-913-1812