Provider Demographics
NPI:1629216544
Name:BILLINGSLEY CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:BILLINGSLEY CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BILLINGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-784-9311
Mailing Address - Street 1:4940 S EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-5937
Mailing Address - Country:US
Mailing Address - Phone:317-784-9311
Mailing Address - Fax:317-784-9395
Practice Address - Street 1:4940 S EMERSON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-5937
Practice Address - Country:US
Practice Address - Phone:317-784-9311
Practice Address - Fax:317-784-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty