Organization
HAMMOND CHIROPRACTIC LIFE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD EUGENE DAULTON SR. D.C. (PRESIDENT)
(219) 932-8900
Entity
Organization
Contact information
Practice address
5716 S HOHMAN AVE, HAMMOND, IN 46320-2319
(219) 932-8900
(219) 932-8944
Mailing address
5716 S HOHMAN AVE, HAMMOND, IN 46320-2319
(219) 932-8900
(219) 932-8944
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000467A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ2555
RAILROAD MEDICARE
IN
Enumeration date
06/07/2007
Last updated
12/10/2007
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