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Jordan R Divine
Chiropractor in Loogootee, Indiana
NPI 1407146582

Jordan R Divine is a Chiropractor based in Loogootee, IN. Jordan R Divine practices in Loogootee, IN. The NPI Number for Jordan R Divine is 1407146582 and holds a License No. 08002579A (Indiana).

The current practice location address for Jordan R Divine is 404 N John F Kennedy Ave, Loogootee, IN and can be reached out via phone at 812-295-5600 and via fax at 812-295-5700. You can also correspond with Jordan R Divine through the mailing address at 407 E MAIN ST, LOOGOOTEE, IN - 47553-1241 (mailing address contact number: ).

Location: 404 N John F Kennedy Ave, Loogootee, IN, 47553-1241
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407146582
Provider Name
Jordan R Divine
Credential
Provider Entity Type
Individual
Gender
Male
Address
404 N John F Kennedy Ave, Loogootee, IN, 47553-1241
Phone Number
812-295-5600
Fax Number
812-295-5700
Provider Enumeration Date
04/11/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
404 N John F Kennedy Ave
City
Loogootee
State
Indiana
Zip
47553-1219
Phone Number
812-295-5600
Fax Number
812-295-5700
person
Provider Business Mailing Address Details
Address
407 E Main St
City
Loogootee
State
Indiana
Zip
47553-1241
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
08002579A (Indiana)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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