Healthcare Provider Details

I. General information

NPI: 1679757058
Provider Name (Legal Business Name): GARBER CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8015 W US HIGHWAY 20
SHIPSHEWANA IN
46565-9482
US

IV. Provider business mailing address

8015 W US 20
SHIPSHEWANA IN
46565
US

V. Phone/Fax

Practice location:
  • Phone: 260-768-4333
  • Fax: 260-768-4333
Mailing address:
  • Phone: 260-768-4333
  • Fax: 260-768-4333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002076A
License Number StateIN

VIII. Authorized Official

Name: DR. KELLY SUE GARBER
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 260-768-4333