Provider Demographics
NPI:1336296888
Name:UNITED CHIROPRACTIC
Entity Type:Organization
Organization Name:UNITED CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-774-2998
Mailing Address - Street 1:16095 PROSPERITY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-4259
Mailing Address - Country:US
Mailing Address - Phone:317-774-2998
Mailing Address - Fax:
Practice Address - Street 1:16095 PROSPERITY DR STE 100
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4259
Practice Address - Country:US
Practice Address - Phone:317-774-2998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002074A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0007319468OtherAETNA
IN000000287601OtherANTHEM
IN0007319468OtherAETNA