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Organization
SPINALAID, LLC
Active
Organization
SPINALAID, LLC
Active
Other names
Team Chiropractic, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY LOU DETTMER (OFFICE MANAGER)
(317) 272-4100
Entity
Organization
Contact information
Practice address
106 N STATE ROAD 267, AVON, IN 46123-8475
(317) 272-4100
(317) 272-4110
Mailing address
106 N STATE ROAD 267, AVON, IN 46123-8475
(317) 272-4100
(317) 272-4110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08000607A
IN
111NR0200X
Radiology Chiropractor
08000607A
IN
207Q00000X
Family Medicine Physician
Primary
01017401
IN
2085R0202X
Diagnostic Radiology Physician
99018585A
IN
Other
Enumeration date
05/18/2007
Last updated
12/11/2008
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