Organization
SPINALCARE PHYSICAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A DETTMER D.C. (OWNER)
(317) 272-4100
Entity
Organization
Contact information
Practice address
114 N AVON AVE, AVON, IN 46123-8475
(317) 272-4100
(317) 272-4110
Mailing address
114 N AVON AVE, AVON, IN 46123-8475
(317) 272-4100
(317) 272-4110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IN
208D00000X
General Practice Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
06/21/2012
Last updated
04/26/2017
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