Provider Demographics
NPI:1396916854
Name:MINAR, CASSIE LYNNE (DC)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:LYNNE
Last Name:MINAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-1066
Mailing Address - Country:US
Mailing Address - Phone:317-467-4300
Mailing Address - Fax:317-467-4521
Practice Address - Street 1:1515 N STATE ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1066
Practice Address - Country:US
Practice Address - Phone:317-467-4300
Practice Address - Fax:317-467-4521
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002379A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN08002379AOtherLICENSE
IN000000556195OtherBLUE CROSS / BLUE SHIELD
IN000000556195OtherBLUE CROSS / BLUE SHIELD