Provider Demographics
NPI:1083719058
Name:VANHORN, ROBERT ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALLEN
Last Name:VANHORN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9017 COLDWATER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-2000
Mailing Address - Country:US
Mailing Address - Phone:260-489-8911
Mailing Address - Fax:260-489-7411
Practice Address - Street 1:9017 COLDWATER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-2000
Practice Address - Country:US
Practice Address - Phone:260-489-8911
Practice Address - Fax:260-489-7411
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000981A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN32-0018348OtherTAX ID #
IN100081410AMedicaid
IN197180AMedicare ID - Type Unspecified