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General NPI Number Information
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NPI Number | 1376962480
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Entity Type | Organization
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Legal Business Name | AUBURN CHIROPRACTIC CLINIC P C
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 421 SMITH DR
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City | AUBURN
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State | IN
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Zip | 46706-3655
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Country | US
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Telephone | 260-925-0357
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Fax | 260-925-6074
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Provider Business Mailing Address
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Address Line | 421 SMITH DR
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City | AUBURN
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State | IN
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Zip | 46706-3655
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Country | US
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Telephone | 260-925-0357
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Fax | 260-925-6074
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Authorized Official
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Title or Position | OWNER
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Name | DR. TYLER W CHALFANT
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Credential | D.C.
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Telephone | 260-925-0357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 08001701A
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License Number State | IN
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