Organization
HAMILTON COUNTY CHIROPRACTIC
Active
Other names
Midwest Sport and Spine Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE PAYNE (OFFICE MANAGER)
(317) 776-1061
Entity
Organization
Contact information
Practice address
220 LAKEVIEW DR, NOBLESVILLE, IN 46060-1210
(317) 776-1061
(317) 776-1172
Mailing address
220 LAKEVIEW DR, NOBLESVILLE, IN 46060-1210
(317) 776-1061
(317) 776-1172
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000520918
ANTHEM BLUE CROSS
—
05
—
200846980A
—
IN
Enumeration date
12/18/2006
Last updated
08/09/2023
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