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General NPI Number Information
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NPI Number | 1730453184
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Entity Type | Organization
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Legal Business Name | FIELDS CHIROPRACTIC INC
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 2418 W 16TH ST
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City | BEDFORD
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State | IN
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Zip | 47421
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Country | US
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Telephone | 812-278-3154
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Fax | 812-278-3158
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Provider Business Mailing Address
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Address Line | 2418 W 16TH ST
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City | BEDFORD
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State | IN
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Zip | 47421
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Country | US
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Telephone | 812-278-3154
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Fax | 812-278-3158
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. WILLIAM MICHAEL FIELDS
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Credential | D.C.
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Telephone | 812-278-3154
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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 | 08001867A
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License Number State | IN
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