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General NPI Number Information
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NPI Number | 1760805832
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Entity Type | Organization
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Legal Business Name | PORTERFIELD FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 503 SILHAVY RD SUITE A104
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City | VALPARAISO
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State | IN
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Zip | 46383-4494
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Country | US
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Telephone | 219-850-1031
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Fax |
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Provider Business Mailing Address
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Address Line | 503 SILHAVY RD SUITE A104
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City | VALPARAISO
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State | IN
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Zip | 46383-4494
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Country | US
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Telephone | 219-850-1031
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Fax |
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | RYAN PORTERFIELD
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Credential | D.C.
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Telephone | 219-850-1031
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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 | 08002471A
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License Number State | IN
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