Provider Demographics
NPI:1285805663
Name:ANN E SPINK D.C. CHIROPRACTIC CENTER, P.C.
Entity type:Organization
Organization Name:ANN E SPINK D.C. CHIROPRACTIC CENTER, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES/SEC
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SPINK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:260-482-8592
Mailing Address - Street 1:5933 STONEY CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-4419
Mailing Address - Country:US
Mailing Address - Phone:260-482-8592
Mailing Address - Fax:
Practice Address - Street 1:5933 STONEY CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-4419
Practice Address - Country:US
Practice Address - Phone:260-482-8592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000088011OtherANTHEM
IN000000088011OtherANTHEM