Healthcare Provider Details

I. General information

NPI: 1174611396
Provider Name (Legal Business Name): PAUL B DENIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 CHARLESTOWN RD SUITE 3
NEW ALBANY IN
47150-9497
US

IV. Provider business mailing address

5120 CHARLESTOWN RD SUITE 3
NEW ALBANY IN
47150-9497
US

V. Phone/Fax

Practice location:
  • Phone: 812-944-8000
  • Fax: 812-944-8992
Mailing address:
  • Phone: 812-944-8000
  • Fax: 812-944-8992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number08001418A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number08001418A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: