Jordan R. Divine

Chiropractor · Loogootee, IN

Individual Active NPI

NPI number 1407146582

Practice location

404 N John F Kennedy Ave
Loogootee, IN 47553-1219
Phone
(812) 295-5600
Fax
(812) 295-5700

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NPI record

NPI
1407146582
Entity type
Individual (Type 1)
Enumeration date
April 11, 2011
Last updated
June 28, 2011
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Chiropractor Primary 111N00000X 08002579A IN

Mailing address

407 E Main St
Loogootee, IN 47553-1241

About Jordan Divine

Jordan R. Divine is a healthcare provider registered in the NPI registry with the primary taxonomy Chiropractor (code 111N00000X). The practice location is 404 N John F Kennedy Ave, Loogootee, IN 47553-1219. The NPI number 1407146582 was assigned on April 11, 2011 and the record was last updated on June 28, 2011.

Jordan Divine lists a license in the registry: #08002579A (IN) for Chiropractor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jordan R. Divine?

The NPI number is 1407146582.

What is the phone number of Jordan Divine?

The phone number listed for the practice location is (812) 295-5600.

Where is Jordan Divine located?

404 N John F Kennedy Ave, Loogootee, IN 47553-1219.

What is the taxonomy code for Jordan Divine?

The primary taxonomy code is 111N00000X – Chiropractor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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