Provider Demographics
NPI:1831384858
Name:CHIROPRACTIC HEALTH CONSULTANTS INC. PC
Entity type:Organization
Organization Name:CHIROPRACTIC HEALTH CONSULTANTS INC. PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUTES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:765-662-7362
Mailing Address - Street 1:324 S BOOTS ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952
Mailing Address - Country:US
Mailing Address - Phone:765-662-7362
Mailing Address - Fax:765-662-8494
Practice Address - Street 1:324 S BOOTS ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952
Practice Address - Country:US
Practice Address - Phone:765-662-7362
Practice Address - Fax:765-662-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001945A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty