Healthcare Provider Details

I. General information

NPI: 1962412338
Provider Name (Legal Business Name): ALLEN CHIROPRACTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 E 10TH ST
JEFFERSONVILLE IN
47130
US

IV. Provider business mailing address

1809 E 10TH ST PO BOX 1463
JEFFERSONVILLE IN
47130
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-8977
  • Fax: 812-280-5253
Mailing address:
  • Phone: 812-282-8977
  • Fax: 812-280-5253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001031A
License Number StateIN

VIII. Authorized Official

Name: DR. MARK D ALLEN
Title or Position: CHIROPRACTOR PRESIDENT
Credential: DC
Phone: 812-282-8977