Provider Demographics
NPI:1215112156
Name:ADAM CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:ADAM CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-864-4311
Mailing Address - Street 1:PO BOX 10126
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46411-0126
Mailing Address - Country:US
Mailing Address - Phone:219-864-4311
Mailing Address - Fax:219-864-4339
Practice Address - Street 1:3145 45TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-3291
Practice Address - Country:US
Practice Address - Phone:219-864-4311
Practice Address - Fax:219-864-4339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN231180Medicare PIN