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General NPI Number Information
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NPI Number | 1487884805
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE CHIROPRACTIC
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 902 N OLD STATE RD 67
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City | MOORESVILLE
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State | IN
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Zip | 46158
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Country | US
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Telephone | 317-831-3400
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Fax | 317-831-3424
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Provider Business Mailing Address
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Address Line | 902 N OLD STATE RD 67
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City | MOORESVILLE
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State | IN
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Zip | 46158
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Country | US
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Telephone | 317-831-3400
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Fax | 317-831-3424
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JOSHUA P HEALY
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Credential | D.C.
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Telephone | 317-831-3400
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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 | 08002453A
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License Number State | IN
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