Individual
MR. JOSEPH DOMENIC FORTUNATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6321 N KEYSTONE AVE STE A, INDIANAPOLIS, IN 46220-2156
(317) 257-2225
(317) 257-0646
Mailing address
6321 N KEYSTONE AVE STE A, INDIANAPOLIS, IN 46220-2156
(317) 257-2225
(317) 257-0646
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001070A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091939
ANTHEM BC/BS
IN
05
—
100120180A
—
IN
01
—
4355508
AETNA
IN
Enumeration date
01/03/2006
Last updated
11/12/2024
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