Organization
REGIONAL SPORT AND SPINE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT J BRAUN DC (PHYSICIAN/OWNER)
(219) 465-1140
Entity
Organization
Contact information
Practice address
4004 CAMPBELL ST, VALPARAISO, IN 46385-1773
(219) 465-1140
(219) 465-0903
Mailing address
4004 CAMPBELL ST, VALPARAISO, IN 46385-1773
(219) 465-1140
(219) 465-0903
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08002287A
STATE LICENSE NUMBER
IN
05
—
300009256
—
IN
Enumeration date
09/11/2018
Last updated
09/11/2018
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