Provider Demographics
NPI:1447443429
Name:PALA CHIROPRACTIC, L.L.C.
Entity type:Organization
Organization Name:PALA CHIROPRACTIC, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PALA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-770-1970
Mailing Address - Street 1:14701 CUMBERLAND RD STE 350
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-4375
Mailing Address - Country:US
Mailing Address - Phone:317-770-1970
Mailing Address - Fax:317-770-4386
Practice Address - Street 1:14701 CUMBERLAND RD STE 350
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4375
Practice Address - Country:US
Practice Address - Phone:317-770-1970
Practice Address - Fax:317-770-4386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002276A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty