Organization
NILL FAMILY CHIROPRACTIC & WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES PATRICK NILL D.C. (OWNER)
(260) 459-2205
Entity
Organization
Contact information
Practice address
4606 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 459-2205
(260) 459-2209
Mailing address
4606 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 459-2205
(260) 459-2209
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002139A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000322869
ANTHEM BC/BS
IN
01
—
1649228677
DR. NILL INDIVIDUAL NPI#
IN
Enumeration date
09/20/2007
Last updated
09/20/2007
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