MEDICARE: ALLEN CHIROPRACTIC PAIN RELIEF SERVICES, 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	08000525A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000084753	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1336357474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN CHIROPRACTIC PAIN RELIEF SERVICES, P.C.

Provider Business Mailing Address
First Line	:	2321 N MARR RD
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203-3445
Country	:	US
Telephone Number	:	812-376-3621
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 N MARR RD
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203-3445
Country	:	US
Telephone Number	:	812-376-3621
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK A ALLEN
Credential	:	D.C.
Telephone Number	:	812-376-3621

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2020

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