MR. MARVIN MICHAEL VANTIEM JR. (NPI# 1144398991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144398991 |
| Entity Type | Individual |
| Full Name | MR. MARVIN MICHAEL VANTIEM JR. |
| Credential | DC |
| Practice Address |
920 W Broadway Monticello IN 47960 |
| Mailing Address |
920 W Broadway Po Box 622 Monticello IN 47960 |
| Practice Telephone | 5745835811 |
| Practice Fax Number | 5745830949 |
| Mailing Telephone | 5745835811 |
| Mailing Fax Number | 5745830949 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 586 | IN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 000000184607 | 01 |
| Street Address |
920 W BROADWAY |
| City | MONTICELLO |
| State | IN |
| Zip Code | 47960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255743472 | Suzanne Reber | Pharmacist | 4901 Sr 26th E, Lafayette, IN 47960 | 2014-05-22 |
| 1588075949 | Theodore Eckerle | Social Worker | 920 West Executive Court, Monticello, IN 47960 | 2014-05-19 |
| 1598805723 | Twin Lakes School Corporation | Local Education Agency (LEA) | 565 S Main Street, Monticello, IN 47960 | 2007-02-07 |
| 1003904806 | Forest Richard Robertson II | Dentist | 515 S Illinois St, Monticello, IN 47960 | 2006-10-10 |
| 1447345889 | Linda Jean Feuquay | Counselor | 207 N. Bluff St., Monticello, IN 47960 | 2006-10-03 |
| 1548270697 | Cdc Resources Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5053 Norway Rd, Monticello, IN 47960 | 2006-08-09 |
| 1528040516 | The Eye Center Group LLC | Optometrist | 1101 O'connor Blvd, Monticello, IN 47960 | 2005-11-16 |
| 1861489254 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1120 N Main St, Monticello, IN 47960 | 2005-09-30 |
| 1467890293 | White County Community Counseling Services LLC | Counselor | 126 S Main St, Monticello, IN 47960 | 2013-06-14 |
| 1144589813 | Angelique Witlam | Physical Therapist | 906 W. Executive Court, Monticello, IN 47960 | 2012-05-15 |
| Find all providers in zip 47960 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750857116 | Tyler Collins | Chiropractor | 106 N Hyatt St, Monticello, AR 71655-4022 | 2018-10-23 |
| 1013373703 | Craig Chiropractic and Kinesiology PC | Chiropractor | 611 Walnut St Ste 2, Monticello, MN 55362-4575 | 2016-01-11 |
| 1750795928 | Paws Up Animal Chiropractic LLC | Chiropractor | 9308 Oriole Ln, Monticello, MN 55362-2860 | 2014-06-16 |
| 1093136434 | Eubanks Chiropractic LLC | Chiropractor | 604 W Bolling St, A, Monticello, AR 71655-5410 | 2014-01-03 |
| 1255752507 | Atlas Advantage Chiropractic L.L.C. | Chiropractor | 9766 Fallon Ave Ne, Suite 104, Monticello, MN 55362-4588 | 2014-01-03 |
| 1164859203 | Dustin Clint Eubanks | Chiropractor | 604 A West Bolling Street, Monticello, AR 71655 | 2013-10-03 |
| 1013266188 | Back Home Chiropractic, LLC | Chiropractor | 818 W 1st St Ste 101, Monticello, IA 52310-1307 | 2012-09-05 |
| 1154618676 | Bennett Barker | Chiropractor | 530 Walnut St, Monticello, MN 55362-8663 | 2011-07-05 |
| 1265768220 | Back 2 Health Chiropractic, P.a. | Chiropractor | 1125 South Cedar St, Suite 109, Monticello, MN 55362 | 2009-10-27 |
| 1053510214 | Shaun Paul Craig | Chiropractor | 506 Cedar St, Monticello, MN 55362-8403 | 2007-07-17 |
| Find all providers in MONTICELLO | ||||
| City | MONTICELLO |
| Zip Code | 47960 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.