Provider Demographics
NPI:1154575983
Name:WENIG CHIROPRACTIC CLINIC, PC
Entity type:Organization
Organization Name:WENIG CHIROPRACTIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE & BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:SHONDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MILLSAPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-875-9800
Mailing Address - Street 1:8317 MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3635
Mailing Address - Country:US
Mailing Address - Phone:317-875-9800
Mailing Address - Fax:317-875-9925
Practice Address - Street 1:8317 MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3635
Practice Address - Country:US
Practice Address - Phone:317-875-9800
Practice Address - Fax:317-875-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100128770AMedicaid
IN332140Medicare PIN