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Organization

BOTTORFF CHIROPRACTIC CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JANELLE A BOTTORFF D.C (OWNER)
(574) 936-2965
Entity
Organization

Contact information

Practice address
315 E JEFFERSON ST, PLYMOUTH, IN 46563-1825
(574) 936-2965
(574) 936-5506
Mailing address
315 E JEFFERSON ST, PLYMOUTH, IN 46563-1825
(574) 936-2965
(574) 936-5506

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001367
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000189745
GROUP
IN
05
100173320A
IN
01
15160332
GROUP
IA
Enumeration date
06/04/2007
Last updated
06/27/2008
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