Organization
CLEAR CHIROPRACTIC MUNCIE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY A RICHARDSON (BILLING MANAGER)
(260) 726-3065
Entity
Organization
Contact information
Practice address
3895 N WHEELING AVE, MUNCIE, IN 47304-1776
(765) 288-8851
(765) 288-8840
Mailing address
406 W VOTAW ST, PORTLAND, IN 47371-1344
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000919097
BLUE CROSS AND BLUE SHIELD
IN
05
—
200936780D
—
IN
Enumeration date
07/16/2019
Last updated
07/16/2019
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