Healthcare Provider Details

I. General information

NPI: 1932299229
Provider Name (Legal Business Name): MCKEE CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2006
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 E MAIN ST
GAS CITY IN
46933-1621
US

IV. Provider business mailing address

1038 E MAIN ST
GAS CITY IN
46933-1621
US

V. Phone/Fax

Practice location:
  • Phone: 765-674-3642
  • Fax:
Mailing address:
  • Phone: 765-674-3642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001842
License Number StateIN

VIII. Authorized Official

Name: JEREMY WILLIAM MCKEE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 765-674-2490