Provider Demographics
NPI:1699381525
Name:EXCELLENCE CHIROPRACTIC & WELLNESS, LLC
Entity Type:Organization
Organization Name:EXCELLENCE CHIROPRACTIC & WELLNESS, LLC
Other - Org Name:ALIGNLIFE OF FISHERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:MACKENZIE
Authorized Official - Last Name:GEARHEART
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:765-499-8376
Mailing Address - Street 1:10298 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9497
Mailing Address - Country:US
Mailing Address - Phone:317-747-0088
Mailing Address - Fax:
Practice Address - Street 1:10298 E 96TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9497
Practice Address - Country:US
Practice Address - Phone:317-747-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty