Provider Demographics
NPI:1497288302
Name:MOSIER FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MOSIER FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-883-9779
Mailing Address - Street 1:304 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:47167-2120
Mailing Address - Country:US
Mailing Address - Phone:812-883-9779
Mailing Address - Fax:812-883-9778
Practice Address - Street 1:304 E MARKET ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-2120
Practice Address - Country:US
Practice Address - Phone:812-883-9779
Practice Address - Fax:812-883-9778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002919A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty