Provider Demographics
NPI:1114596152
Name:GLADISH CHIROPRACTIC AND ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:GLADISH CHIROPRACTIC AND ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GLADISH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-547-8692
Mailing Address - Street 1:1430 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-1404
Mailing Address - Country:US
Mailing Address - Phone:812-547-8692
Mailing Address - Fax:812-547-8694
Practice Address - Street 1:1430 MAIN ST
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-1404
Practice Address - Country:US
Practice Address - Phone:812-547-8692
Practice Address - Fax:812-547-8694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty