NPI 1205933165 · live from the CMS NPI Registry
Allen County Family & Sports Chiropractic
Chiropractor, Sports Physician in Fort Wayne, IN. National Provider Identifier 1205933165, active.
NPI record
| NPI | 1205933165 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor, Sports Physician 111NS0005X |
| Practice location | 3835 W Jefferson Blvd, Fort Wayne, IN 46804 |
| Practice phone | 260-432-7339 |
| Enumerated | September 20, 2006 |
| Last updated | September 11, 2025 |
| Authorized official | Monique Levesque-Hartle, Vice President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor, Nutrition | 111NN1001X | 08001638 (IN) |
| Chiropractor, Sports Physician primary | 111NS0005X | 08001622 (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.