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General NPI Number Information
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NPI Number | 1497473409
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Entity Type | Organization
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Legal Business Name | WHOLE BODY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 1709 E BRISTOL ST
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City | ELKHART
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State | IN
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Zip | 46514-6606
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Country | US
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Telephone | 157-426-4917
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Fax |
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Provider Business Mailing Address
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Address Line | 106 S BROOK AVE
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City | MISHAWAKA
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State | IN
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Zip | 46544-3354
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Country | US
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Telephone | 574-323-3271
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MICHAEL DEAN HUMMER
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Credential | DC
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Telephone | 574-323-3271
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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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