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General NPI Number Information
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NPI Number | 1275279325
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Entity Type | Organization
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Legal Business Name | VINCENNES MEDICAL & CHIROPRACTIC GROUP
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 2801 N 6TH ST STE F
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City | VINCENNES
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State | IN
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Zip | 47591-3660
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Country | US
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Telephone | 812-790-3569
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Fax | 812-817-0944
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Provider Business Mailing Address
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Address Line | 2801 N 6TH ST
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City | VINCENNES
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State | IN
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Zip | 47591-3659
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Country | US
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Telephone | 812-790-3569
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Fax | 812-817-0944
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS W WELLBROOK
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Credential | DC
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Telephone | 812-790-3569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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