Healthcare Provider Details

I. General information

NPI: 1861879306
Provider Name (Legal Business Name): INDIANA FAMILY CHIROPRACTIC CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 STATE ROAD 39 BYP S
MARTINSVILLE IN
46151-2458
US

IV. Provider business mailing address

1100 STATE ROAD 39 BYP S
MARTINSVILLE IN
46151-2458
US

V. Phone/Fax

Practice location:
  • Phone: 812-272-3700
  • Fax: 812-333-7442
Mailing address:
  • Phone: 765-315-0680
  • Fax: 765-315-0681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CURTIS LEGG
Title or Position: OWNER
Credential: DC
Phone: 765-315-0680