NPI 1730209479 · live from the CMS NPI Registry
A Family Chiropractic Center, PC
Chiropractor in Mishawaka, IN. National Provider Identifier 1730209479, active.
NPI record
| NPI | 1730209479 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 535 Lincoln Way W, Mishawaka, IN 46544 |
| Practice phone | 574-255-1716 |
| Enumerated | March 29, 2007 |
| Last updated | August 22, 2020 |
| Authorized official | Bryan Glenn, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor primary | 111N00000X | 51000342A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.