Provider Demographics
NPI:1982813937
Name:MYERS CHIROPRACTIC ARTS CENTER, PC
Entity Type:Organization
Organization Name:MYERS CHIROPRACTIC ARTS CENTER, PC
Other - Org Name:CHIROPRACTIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-464-4444
Mailing Address - Street 1:2403 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-2305
Mailing Address - Country:US
Mailing Address - Phone:219-464-4444
Mailing Address - Fax:219-464-3409
Practice Address - Street 1:2403 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-2305
Practice Address - Country:US
Practice Address - Phone:219-464-4444
Practice Address - Fax:219-464-3409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000483A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN327790AMedicare ID - Type UnspecifiedMEDICARE ID
IN000000084937Medicare UPIN