Provider Demographics
NPI:1730635335
Name:FAMILY SPINAL ADJUSTING, LLC
Entity Type:Organization
Organization Name:FAMILY SPINAL ADJUSTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:574-773-3423
Mailing Address - Street 1:110 E. MARKET ST.
Mailing Address - Street 2:
Mailing Address - City:NAPPANEE
Mailing Address - State:IN
Mailing Address - Zip Code:46550-2130
Mailing Address - Country:US
Mailing Address - Phone:574-773-3423
Mailing Address - Fax:
Practice Address - Street 1:110 E MARKET ST
Practice Address - Street 2:
Practice Address - City:NAPPANEE
Practice Address - State:IN
Practice Address - Zip Code:46550-2130
Practice Address - Country:US
Practice Address - Phone:574-773-3423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001556261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center