Provider Demographics
NPI:1861832248
Name:NOBLESVILLE FAMILY CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:NOBLESVILLE FAMILY CHIROPRACTIC, LTD
Other - Org Name:NOBLESVILLE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAHLAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-699-6840
Mailing Address - Street 1:953 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2603
Mailing Address - Country:US
Mailing Address - Phone:317-214-7218
Mailing Address - Fax:317-314-7213
Practice Address - Street 1:953 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2603
Practice Address - Country:US
Practice Address - Phone:317-214-7218
Practice Address - Fax:317-314-7213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002715A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty