Organization
MCHC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G MASON D.C. (OWNER)
(317) 577-9558
Entity
Organization
Contact information
Practice address
11595 ALLISONVILLE RD, FISHERS, IN 46038-1863
(317) 577-9558
(317) 577-9559
Mailing address
11595 ALLISONVILLE RD, FISHERS, IN 46038-1863
(317) 577-9558
(317) 577-9559
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002072A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000298183
ANTHEM BCBS
—
Enumeration date
02/22/2008
Last updated
07/02/2008
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