Provider Demographics
NPI:1245417500
Name:DIANE M VUOTTO
Entity Type:Organization
Organization Name:DIANE M VUOTTO
Other - Org Name:BACK PAIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VUOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-898-6989
Mailing Address - Street 1:8130 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-6833
Mailing Address - Country:US
Mailing Address - Phone:317-898-6989
Mailing Address - Fax:317-257-7178
Practice Address - Street 1:2127 E 71ST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1307
Practice Address - Country:US
Practice Address - Phone:317-253-2888
Practice Address - Fax:317-257-7178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001303A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty