Provider Demographics
NPI:1013642198
Name:NEW BEGINNINGS CHIROPRACTIC OF WILLISBURG PLLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS CHIROPRACTIC OF WILLISBURG PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-583-3842
Mailing Address - Street 1:PO BOX 2257
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-2257
Mailing Address - Country:US
Mailing Address - Phone:859-374-1479
Mailing Address - Fax:859-239-0044
Practice Address - Street 1:2084 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLISBURG
Practice Address - State:KY
Practice Address - Zip Code:40078-8199
Practice Address - Country:US
Practice Address - Phone:859-374-1479
Practice Address - Fax:859-239-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty