Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 08001701A | IN |
NPI | 1194764332 |
---|---|
Provider Name | Dr. Tyler Wayne Chalfant |
First Address | Auburn, IN 46706-3655 |
Second Address | Auburn, IN 46706-3655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 08/07/2007 |