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General NPI Number Information
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NPI Number | 1821411455
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Entity Type | Organization
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Legal Business Name | ABOVE ALL CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 03/21/2014
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Provider Practice Location Address
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Address Line | 1722 EAST DAY RD.
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City | MISHAWAKA
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State | IN
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Zip | 46545-4300
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Country | US
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Telephone | 574-222-2625
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Fax | 574-222-2625
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Provider Business Mailing Address
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Address Line | 1722 EAST DAY RD.
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City | MISHAWAKA
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State | IN
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Zip | 46545-4300
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Country | US
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Telephone | 574-222-2625
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Fax | 574-222-2625
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Authorized Official
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Title or Position | PRESIDENT/PROVIDER
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Name | DR. RYAN ALAN MORNINGSTAR
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Credential | DC
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Telephone | 574-222-2625
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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 | 08002752A
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License Number State | IN
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