Provider Demographics
NPI:1992909949
Name:AMERICAN CHIROPRACTIC AND WELLNESS
Entity type:Organization
Organization Name:AMERICAN CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SABETI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:765-622-0600
Mailing Address - Street 1:PO BOX 3145
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46018-3145
Mailing Address - Country:US
Mailing Address - Phone:765-622-0600
Mailing Address - Fax:
Practice Address - Street 1:3003 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-1259
Practice Address - Country:US
Practice Address - Phone:765-622-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN219360Medicare ID - Type UnspecifiedMEDICARE GROUP #