Healthcare Provider Details

I. General information

NPI: 1902036916
Provider Name (Legal Business Name): WITTMAN FAMILY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2009
Last Update Date: 06/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2072 N COUNTY ROAD 700 W
RICHLAND IN
47634-9480
US

IV. Provider business mailing address

7803 WEST ST RD 66
RICHLAND IN
47634-9122
US

V. Phone/Fax

Practice location:
  • Phone: 812-359-4012
  • Fax: 812-359-4481
Mailing address:
  • Phone: 812-359-4012
  • Fax: 812-359-4481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. REBEKAH ANN WITTMAN
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C
Phone: 812-359-4523