Provider Demographics
NPI:1770341497
Name:HEBRON WOODS CHIROPRACTIC AND ACUPUNCTURE LLC
Entity type:Organization
Organization Name:HEBRON WOODS CHIROPRACTIC AND ACUPUNCTURE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:POPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-509-5484
Mailing Address - Street 1:634 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:IN
Mailing Address - Zip Code:46341-9205
Mailing Address - Country:US
Mailing Address - Phone:219-509-3284
Mailing Address - Fax:
Practice Address - Street 1:634 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:IN
Practice Address - Zip Code:46341-9205
Practice Address - Country:US
Practice Address - Phone:219-509-3284
Practice Address - Fax:219-509-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty