MEDICARE: VANHORN CHIROPRACTIC CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	08000981	IN

General Provider Information

NPI Number	:	1134247737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANHORN CHIROPRACTIC CENTER, INC

Provider Business Mailing Address
First Line	:	9017 COLDWATER RD
Second Line	:	SUITE 200
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-2000
Country	:	US
Telephone Number	:	260-489-8911
Fax Number	:	260-489-7411

Provider Business Practice Location Address
First Line	:	9017 COLDWATER RD
Second Line	:	SUITE 200
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-2000
Country	:	US
Telephone Number	:	260-489-8911
Fax Number	:	260-489-7411

Authorized Official
Title or Position	:	INSURANCE BILLING
Name	:	MRS. STACI COUNTERMAN
Credential	:
Telephone Number	:	260-489-8911

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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