Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 08002960A | IN |
N | 111NR0400X | Rehabilitation Chiropractor | 08002960A | IN |
N | 111NS0005X | Chiropractic Sports Physician | 08002960A | IN |
NPI | 1265979272 |
---|---|
Provider Name | Lauren Harden |
First Address | Indianapolis, IN 46228-1374 |
Second Address | Indianapolis, IN 46228-1374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2017 |
Last Update Date | 28/01/2017 |