Provider Demographics
NPI:1841676046
Name:CHIROPRACTIC HEALTH AND MAX PERFORMANCE, LLC
Entity type:Organization
Organization Name:CHIROPRACTIC HEALTH AND MAX PERFORMANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-219-4980
Mailing Address - Street 1:9625 E 150 ST
Mailing Address - Street 2:STE 105
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-5626
Mailing Address - Country:US
Mailing Address - Phone:317-219-4980
Mailing Address - Fax:331-442-4902
Practice Address - Street 1:9625 E 150 ST
Practice Address - Street 2:STE 105
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-5626
Practice Address - Country:US
Practice Address - Phone:317-219-4980
Practice Address - Fax:331-442-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002635A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty