Provider Demographics
NPI:1700987948
Name:TSCHETTER, DELTAN JON (DC)
Entity type:Individual
Prefix:DR
First Name:DELTAN
Middle Name:JON
Last Name:TSCHETTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N ARLINGTON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3260
Mailing Address - Country:US
Mailing Address - Phone:317-375-3673
Mailing Address - Fax:317-352-8143
Practice Address - Street 1:1311 N ARLINGTON AVE STE 103
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3260
Practice Address - Country:US
Practice Address - Phone:317-375-3673
Practice Address - Fax:317-352-8143
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001697A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN677930Medicare ID - Type Unspecified