Provider Demographics
NPI:1588859474
Name:MT VERNON CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:MT VERNON CHIROPRACTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAY-WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-838-6768
Mailing Address - Street 1:722 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47620-1960
Mailing Address - Country:US
Mailing Address - Phone:812-838-6768
Mailing Address - Fax:812-838-6468
Practice Address - Street 1:722 MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IN
Practice Address - Zip Code:47620-1960
Practice Address - Country:US
Practice Address - Phone:812-838-6768
Practice Address - Fax:812-838-6468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002158A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1154401487OtherNIP
IN200502840Medicaid
IN1154401487OtherNIP
IN200502840Medicaid