Back To Health Wellness Center, P.c, | |
2504 Monroe St, La Porte, IN 46350-5241 | |
(219) 326-5100 | |
(219) 326-0180 |
Full Name | Back To Health Wellness Center, P.c, |
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Type | Facility |
Speciality | Chiropractor |
Location | 2504 Monroe St, La Porte, Indiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922245836 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Matthew C Kirkham |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1841208865 PECOS PAC ID: 7810044948 Enrollment ID: I20090407000470 |
Mailing Address | Practice Location Address |
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Back To Health Wellness Center, P.c, 2504 Monroe St, La Porte, IN 46350-5241 Ph: (219) 326-5100 | Back To Health Wellness Center, P.c, 2504 Monroe St, La Porte, IN 46350-5241 Ph: (219) 326-5100 |
Mrs. Shanna Gail Dudash, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1108 Indiana Ave, La Porte, IN 46350 Phone: 219-362-5433 Fax: 219-362-0027 | |
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