Provider Demographics
NPI:1952631012
Name:HEALTH CENTERED SPINE & WELLNESS
Entity Type:Organization
Organization Name:HEALTH CENTERED SPINE & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:GALYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-519-2963
Mailing Address - Street 1:1725 E TIPTON ST
Mailing Address - Street 2:STE. 200
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-3561
Mailing Address - Country:US
Mailing Address - Phone:812-519-2963
Mailing Address - Fax:812-519-3515
Practice Address - Street 1:1725 E TIPTON ST
Practice Address - Street 2:STE. 200
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-3561
Practice Address - Country:US
Practice Address - Phone:812-519-2963
Practice Address - Fax:812-519-3515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN8001579111N00000X
IN01036180A207LP2900X
IN71001567A363LA2200X
IN71004638A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN6412290001OtherDME PTAN
IN200976980CMedicaid
IN200976980AMedicaid
IN200976980AMedicaid
IN6412290001Medicare NSC