# SPINALAID, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Team Chiropractic, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932317666
- **Authorized official:** MRS. MARY LOU DETTMER (OFFICE MANAGER)
- **Authorized official phone:** (317) 272-4100

## Contact information

- **Practice address:** 106 N STATE ROAD 267, AVON, IN 46123-8475
- **Practice address phone:** (317) 272-4100
- **Practice address fax:** (317) 272-4110
- **Mailing address:** 106 N STATE ROAD 267, AVON, IN 46123-8475
- **Mailing address phone:** (317) 272-4100
- **Mailing address fax:** (317) 272-4110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 08000607A | IN | — |
| 111NR0200X | Radiology Chiropractor | 08000607A | IN | — |
| 207Q00000X | Family Medicine Physician | 01017401 | IN | Yes |
| 2085R0202X | Diagnostic Radiology Physician | 99018585A | IN | — |

## Other

- **Enumeration date:** 05/18/2007
- **Last updated:** 12/11/2008