Healthcare Provider Details

I. General information

NPI: 1407331556
Provider Name (Legal Business Name): SIMPLY CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16095 PROSPERITY DR STE 100
NOBLESVILLE IN
46060-4320
US

IV. Provider business mailing address

7623 MADDEN LN
FISHERS IN
46038-1303
US

V. Phone/Fax

Practice location:
  • Phone: 317-774-2998
  • Fax: 317-774-3130
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW FERRIS
Title or Position: OWNER
Credential: DC
Phone: 317-774-2998