Provider Demographics
NPI:1619429826
Name:BARANOWSKI SPINALCARE LLC
Entity Type:Organization
Organization Name:BARANOWSKI SPINALCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:574-264-9174
Mailing Address - Street 1:1709 E. BRISTOL ST.
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-4553
Mailing Address - Country:US
Mailing Address - Phone:574-264-9174
Mailing Address - Fax:574-262-4070
Practice Address - Street 1:1709 E. BRISTOL ST.
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-4553
Practice Address - Country:US
Practice Address - Phone:574-264-9174
Practice Address - Fax:574-262-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002547A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty