MEDICARE: COLETTE ANDREA HITTNER D.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	08002500A	IN

General Provider Information

NPI Number	:	1326361999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLETTE ANDREA HITTNER D.C.

Provider Business Mailing Address
First Line	:	6612 EAST 75TH STREET
Second Line	:	SUITE 110
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2821
Country	:	US
Telephone Number	:	317-288-5480
Fax Number	:	317-288-5481

Provider Business Practice Location Address
First Line	:	6612 EAST 75TH STREET
Second Line	:	SUITE 110
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2821
Country	:	US
Telephone Number	:	317-288-5480
Fax Number	:	317-288-5481

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2010
Last Update Date	:	03/10/2010

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