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General NPI Number Information
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NPI Number | 1447461132
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Entity Type | Organization
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Legal Business Name | NEWBURGH CHIROPRACTIC PSC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 8211 W STATE ROUTE 66
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City | NEWBURGH
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State | IN
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Zip | 47630-2534
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Country | US
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Telephone | 812-858-1008
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Fax | 812-858-1001
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Provider Business Mailing Address
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Address Line | 8211 W STATE ROUTE 66
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City | NEWBURGH
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State | IN
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Zip | 47630-2534
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Country | US
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Telephone | 812-858-1008
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Fax | 812-858-1001
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SHAUN P TYMCHAK
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Credential | D.C.
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Telephone | 812-858-1008
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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 | 08002011A
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License Number State | IN
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