Provider Demographics
NPI:1679757058
Name:GARBER CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:GARBER CHIROPRACTIC, INC.
Other - Org Name:5 & 20 CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:260-768-4333
Mailing Address - Street 1:8015 W US 20
Mailing Address - Street 2:
Mailing Address - City:SHIPSHEWANA
Mailing Address - State:IN
Mailing Address - Zip Code:46565
Mailing Address - Country:US
Mailing Address - Phone:260-768-4333
Mailing Address - Fax:260-768-4333
Practice Address - Street 1:8015 W US HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:SHIPSHEWANA
Practice Address - State:IN
Practice Address - Zip Code:46565-9482
Practice Address - Country:US
Practice Address - Phone:260-768-4333
Practice Address - Fax:260-768-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002076A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN234890Medicare PIN