NPI 1457649857

Divine Chiropractic LLC

Organisation Preferred Provider Organization Loogootee, IN

Practice location

Address: 404 North John F Kennedy Avenue, Loogootee, IN 47553
Phone: (812) 295-5600

Authorised official

Name: Jordan Divine
Title: Manager
Phone: (812) 295-5600

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 08002579A (IN)

Other Preferred Provider Organization providers in Indiana →

Registry record

NPI: 1457649857
Entity type: Organization
NPI issued: 19 Jul 2011
Record last updated: 19 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.