Provider Demographics
NPI:1003604166
Name:RIVER VALLEY CLINIC OF CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:RIVER VALLEY CLINIC OF CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:HORRALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-240-0555
Mailing Address - Street 1:113 S WHITE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-8106
Mailing Address - Country:US
Mailing Address - Phone:618-240-0555
Mailing Address - Fax:618-240-0555
Practice Address - Street 1:113 S WHITE CHURCH RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-8106
Practice Address - Country:US
Practice Address - Phone:618-240-0555
Practice Address - Fax:618-240-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center