MEDICARE: CHIROPRACTIC HEALTH 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	08000142A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	230760	OTHER	IN	MEDICARE ID

Other Identifiers

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

General Provider Information

NPI Number	:	1760527709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC HEALTH SERVICES, P.C.

Provider Business Mailing Address
First Line	:	4222 HOBSON CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-8648
Country	:	US
Telephone Number	:	260-485-3146
Fax Number	:	260-486-5278

Provider Business Practice Location Address
First Line	:	4222 HOBSON CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-8648
Country	:	US
Telephone Number	:	260-485-3146
Fax Number	:	260-486-5278

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JON ROBERT ALTER
Credential	:	D.C.
Telephone Number	:	260-485-3146

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	06/20/2008

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Directions to “CHIROPRACTIC HEALTH SERVICES, P.C. ” Practice Location

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