David Fenderson, | |
1460 W 86th St, Indianapolis, IN 46260-2181 | |
(317) 679-1858 | |
Not Available |
Full Name | David Fenderson |
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Gender | Male |
Speciality | Chiropractor |
Location | 1460 W 86th St, Indianapolis, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013638048 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 08003322A (Indiana) | Primary |
Provider Name | Indy Family Chiropractic Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1669893954 PECOS PAC ID: 6507096849 Enrollment ID: O20140305001720 |
Mailing Address | Practice Location Address |
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David Fenderson, 12535 Talon Crest Dr, Fishers, IN 46037-4003 Ph: () - | David Fenderson, 1460 W 86th St, Indianapolis, IN 46260-2181 Ph: (317) 679-1858 |
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