Provider Demographics
NPI:1639546070
Name:INDIANAPOLIS INTEGRATIVE HEALTH AND REHABILITATION INC
Entity Type:Organization
Organization Name:INDIANAPOLIS INTEGRATIVE HEALTH AND REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:C
Authorized Official - Last Name:EKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-454-2147
Mailing Address - Street 1:55 S STATE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-3802
Mailing Address - Country:US
Mailing Address - Phone:317-638-3111
Mailing Address - Fax:317-672-7540
Practice Address - Street 1:55 S STATE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-3802
Practice Address - Country:US
Practice Address - Phone:317-638-3111
Practice Address - Fax:317-672-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty