Healthcare Provider Details

I. General information

NPI: 1356208557
Provider Name (Legal Business Name): JORDAN COREY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1729 E MAIN ST
PLAINFIELD IN
46168-1812
US

IV. Provider business mailing address

5809 HEMLOCK DR
WHITESTOWN IN
46075-4467
US

V. Phone/Fax

Practice location:
  • Phone: 317-838-8839
  • Fax:
Mailing address:
  • Phone: 765-376-3118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08003583A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: