Provider Demographics
NPI:1699960682
Name:HEALTH 1ST CHIROPRACTIC OF PLAINFIELD INC.
Entity type:Organization
Organization Name:HEALTH 1ST CHIROPRACTIC OF PLAINFIELD INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-839-6686
Mailing Address - Street 1:1660 E MAIN ST
Mailing Address - Street 2:STE. 103
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-2811
Mailing Address - Country:US
Mailing Address - Phone:317-839-6686
Mailing Address - Fax:317-839-7247
Practice Address - Street 1:6326 RUCKER RD STE F
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4861
Practice Address - Country:US
Practice Address - Phone:317-253-1644
Practice Address - Fax:317-253-9708
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH 1ST CHIROPRACTIC OF PLAINFIELD INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-12
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002191A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200975580AMedicaid
IN300035721Medicaid