Provider Demographics
NPI:1154661858
Name:HEALTH FIRST CHIROPRACTIC OF WESTFIELD INC.
Entity Type:Organization
Organization Name:HEALTH FIRST CHIROPRACTIC OF WESTFIELD INC.
Other - Org Name:HEALTH1ST CHIROPRACTIC OF WESTFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOONG
Authorized Official - Middle Name:HOON
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-839-6686
Mailing Address - Street 1:17441 CAREY RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-9439
Mailing Address - Country:US
Mailing Address - Phone:317-867-4193
Mailing Address - Fax:317-867-4259
Practice Address - Street 1:17441 CAREY RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-9439
Practice Address - Country:US
Practice Address - Phone:317-867-4193
Practice Address - Fax:317-867-4259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201147370AMedicaid