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NPI Code Detail

MEDICARE: EDGEWOOD CHIROPRACTIC CENTER PC

MEDICARE: EDGEWOOD CHIROPRACTIC CENTER PC
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
1111N00000XChiropractor8001619IN

General Provider Information

NPI Number : 1427260793
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDGEWOOD CHIROPRACTIC CENTER PC
Provider Business Mailing Address
First Line : 1114 W COOK RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-3214
Country : US
Telephone Number : 260-483-5588
Fax Number : 260-489-1819
Provider Business Practice Location Address
First Line : 1114 W COOK RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-3214
Country : US
Telephone Number : 260-483-5588
Fax Number : 260-489-1819
Authorized Official
Title or Position : CO-OWNER
Name : DR. CHRISTINA M BOLINGER
Credential : DC
Telephone Number : 260-483-5588
Provider Enumeration Date : 05/07/2007
Last Update Date : 01/08/2009

Similar Medicare Providers

1689683708 — DR. CHRISTINA M BOLINGER DC
Practice Location Address:
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46825-3214
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Practice Fax: 260-489-1819
1073522108 — TRENTON G BOGGS DC
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1922473503 — ANDREW SCHOTT
Practice Location Address:
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FORT WAYNE, IN
46825-3214
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Practice Fax: 260-489-1819
1104415660 — CHANDLER BOGGS DC
Practice Location Address:
1114 W COOK RD
FORT WAYNE, IN
46825-3214
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Practice Fax:
1558945840 — DR. RACHEL DIANNE MADRAGA
Practice Location Address:
1114 W COOK RD
FORT WAYNE, IN
46825-3214
Practice Phone: 260-483-5588
Practice Fax: 260-489-1819

Directions to “EDGEWOOD CHIROPRACTIC CENTER PC ” Practice Location

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