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Chiropractic Providers Chiropractor Sports Physician

Provider NPI: 1427233485

Organization Information:
Organization is not Subpart
Authorized Official:  TIMOTHY J KISTLER  PRESIDENT  317-826-2273

Practice Location:
Tel: 317-826-2273  Fax: 317-826-2673

Business Mailing Address:
Tel: 317-826-2273  Fax: 317-826-2673

NPI Information:
NPI: 1427233485
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y111NS0005XChiropractic Providers
Sports Physician

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 111NS0005X





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