Provider Demographics
NPI:1518068683
Name:CHIROPRACTIC ASSOCIATES INC
Entity Type:Organization
Organization Name:CHIROPRACTIC ASSOCIATES INC
Other - Org Name:COX CHIROPRACTIC MEDICINE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:COX
Authorized Official - Suffix:II
Authorized Official - Credentials:DC LAC
Authorized Official - Phone:260-484-1964
Mailing Address - Street 1:3125 HOBSON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-1611
Mailing Address - Country:US
Mailing Address - Phone:260-484-1964
Mailing Address - Fax:260-471-1817
Practice Address - Street 1:3125 HOBSON RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-1611
Practice Address - Country:US
Practice Address - Phone:260-484-1964
Practice Address - Fax:260-471-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0024197180019261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100080050AMedicaid
IN100080050AMedicaid
IN100080050AMedicaid