Provider Demographics
NPI:1861514184
Name:RASP, JAMES L (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:RASP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:LOYD
Other - Last Name:RASP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6612 EAST 75TH STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2821
Mailing Address - Country:US
Mailing Address - Phone:317-288-5480
Mailing Address - Fax:317-288-5481
Practice Address - Street 1:6612 EAST 75TH STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2821
Practice Address - Country:US
Practice Address - Phone:317-288-5480
Practice Address - Fax:317-288-5481
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001371-A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201810004Medicare PIN
INU29012Medicare UPIN