Provider Demographics
NPI:1861824740
Name:BOYD FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BOYD FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-571-1480
Mailing Address - Street 1:9511 DELEGATES ROW
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3807
Mailing Address - Country:US
Mailing Address - Phone:317-571-1480
Mailing Address - Fax:317-571-1481
Practice Address - Street 1:9511 DELEGATES ROW
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3807
Practice Address - Country:US
Practice Address - Phone:317-571-1480
Practice Address - Fax:317-571-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002707A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty