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NPI Code Detail

MEDICARE: FAULKNER CHIROPRACTIC & ACUPUNCTURE LLC

MEDICARE: FAULKNER CHIROPRACTIC & ACUPUNCTURE 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
1111N00000XChiropractor08001016IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000086964OTHERINANTHEM PIN NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689907826
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAULKNER CHIROPRACTIC & ACUPUNCTURE LLC
Provider Business Mailing Address
First Line : 2205 W SUDBURY DR
Second Line : SUITE B
City : BLOOMINGTON
State : IN
Zip : 47403-3813
Country : US
Telephone Number : 812-333-3131
Fax Number :
Provider Business Practice Location Address
First Line : 2205 W SUDBURY DR
Second Line : SUITE B
City : BLOOMINGTON
State : IN
Zip : 47403-3813
Country : US
Telephone Number : 812-333-3131
Fax Number :
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. BRENDA L FAULKNER
Credential : DC
Telephone Number : 812-333-3131
Provider Enumeration Date : 09/04/2009
Last Update Date : 09/04/2009

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Directions to “FAULKNER CHIROPRACTIC & ACUPUNCTURE LLC ” Practice Location

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