Provider Demographics
NPI:1326361999
Name:HITTNER, COLETTE ANDREA (DC)
Entity Type:Individual
Prefix:
First Name:COLETTE
Middle Name:ANDREA
Last Name:HITTNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6612 EAST 75TH STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2821
Mailing Address - Country:US
Mailing Address - Phone:317-288-5480
Mailing Address - Fax:317-288-5481
Practice Address - Street 1:6612 EAST 75TH STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2821
Practice Address - Country:US
Practice Address - Phone:317-288-5480
Practice Address - Fax:317-288-5481
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002500A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor