MEDICARE: CLEAR CHIROPRACTIC MARION LLC

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

General Provider Information

NPI Number	:	1346015930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR CHIROPRACTIC MARION LLC

Provider Business Mailing Address
First Line	:	1105 N WESTERN AVE
Second Line	:
City	:	MARION
State	:	IN
Zip	:	46952-2501
Country	:	US
Telephone Number	:	765-664-2479
Fax Number	:	765-662-1625

Provider Business Practice Location Address
First Line	:	1105 N WESTERN AVE
Second Line	:
City	:	MARION
State	:	IN
Zip	:	46952-2501
Country	:	US
Telephone Number	:	765-664-2479
Fax Number	:	765-662-1625

Authorized Official
Title or Position	:	OWNER
Name	:	OAKLAND GAERKE
Credential	:	DC
Telephone Number	:	260-726-3065

Provider Enumeration Date	:	11/24/2023
Last Update Date	:	11/24/2023

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