Provider Demographics
NPI:1740378272
Name:LINTON CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:LINTON CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINDSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-847-4330
Mailing Address - Street 1:129 VINCENNES ST E
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-1859
Mailing Address - Country:US
Mailing Address - Phone:812-847-4330
Mailing Address - Fax:
Practice Address - Street 1:129 E VINCENNES ST
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-1859
Practice Address - Country:US
Practice Address - Phone:812-847-4330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDD5393OtherRAILROAD MEDICARE GROUP
INDD5393OtherRAILROAD MEDICARE GROUP