MEDICARE: ANN E SPINK D.C. CHIROPRACTIC CENTER, P.C.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000088011	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1285805663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANN E SPINK D.C. CHIROPRACTIC CENTER, P.C.

Provider Business Mailing Address
First Line	:	5933 STONEY CREEK DRIVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-4419
Country	:	US
Telephone Number	:	260-482-8592
Fax Number	:

Provider Business Practice Location Address
First Line	:	5933 STONEY CREEK DRIVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-4419
Country	:	US
Telephone Number	:	260-482-8592
Fax Number	:

Authorized Official
Title or Position	:	PRES/SEC
Name	:	ANN E SPINK
Credential	:	D.C.
Telephone Number	:	260-482-8592

Provider Enumeration Date	:	03/13/2008
Last Update Date	:	03/13/2008

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