Healthcare Provider Details

I. General information

NPI: 1902946775
Provider Name (Legal Business Name): JARED N HIMSEL DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14350 MUNDY DR STE 1000
NOBLESVILLE IN
46060-7221
US

IV. Provider business mailing address

10403 PLATINUM DR
NOBLESVILLE IN
46060-6125
US

V. Phone/Fax

Practice location:
  • Phone: 765-532-6662
  • Fax:
Mailing address:
  • Phone: 765-532-6662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002313A
License Number StateIN

VIII. Authorized Official

Name: DR. JARED N. HIMSEL
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 765-532-6662