Provider Demographics
NPI:1285815001
Name:ALTER CHIROPRACTIC HEALTH & HEALING P.C.
Entity type:Organization
Organization Name:ALTER CHIROPRACTIC HEALTH & HEALING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:260-497-0999
Mailing Address - Street 1:10331 DAWSONS CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1908
Mailing Address - Country:US
Mailing Address - Phone:260-497-0999
Mailing Address - Fax:260-497-0994
Practice Address - Street 1:10331 DAWSONS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1908
Practice Address - Country:US
Practice Address - Phone:260-497-0999
Practice Address - Fax:260-497-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN51000318A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN167570Medicare PIN