Provider Demographics
NPI:1497473409
Name:WHOLE BODY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:WHOLE BODY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:574-323-3271
Mailing Address - Street 1:106 S BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-3354
Mailing Address - Country:US
Mailing Address - Phone:574-323-3271
Mailing Address - Fax:
Practice Address - Street 1:1709 E BRISTOL ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-6606
Practice Address - Country:US
Practice Address - Phone:157-426-4917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty