Healthcare Provider Details

I. General information

NPI: 1144949348
Provider Name (Legal Business Name): HOOSIER PAIN AND POSTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 E STATE ROAD 68
HAUBSTADT IN
47639-8032
US

IV. Provider business mailing address

1068 E STATE ROAD 68
HAUBSTADT IN
47639-8032
US

V. Phone/Fax

Practice location:
  • Phone: 812-868-7300
  • Fax:
Mailing address:
  • Phone: 812-868-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. BRENT A KAISER
Title or Position: OWNER
Credential: DC
Phone: 908-461-0768