Provider Demographics
NPI:1376748996
Name:VINCENNES CHIROPRACTIC, INC PC
Entity Type:Organization
Organization Name:VINCENNES CHIROPRACTIC, INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:SWEIGART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-886-4427
Mailing Address - Street 1:707 BUSSERON STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591
Mailing Address - Country:US
Mailing Address - Phone:812-886-4427
Mailing Address - Fax:812-886-5868
Practice Address - Street 1:707 BUSSERON STREET
Practice Address - Street 2:SUITE C
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591
Practice Address - Country:US
Practice Address - Phone:812-886-4427
Practice Address - Fax:812-886-5868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000574A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN444320Medicare PIN