Provider Demographics
NPI:1053667659
Name:MERIDIAN CHIROPRACTIC
Entity Type:Organization
Organization Name:MERIDIAN CHIROPRACTIC
Other - Org Name:UNION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-918-6868
Mailing Address - Street 1:9990 OLD UNION RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-9066
Mailing Address - Country:US
Mailing Address - Phone:859-918-6868
Mailing Address - Fax:
Practice Address - Street 1:9990 OLD UNION RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-9066
Practice Address - Country:US
Practice Address - Phone:859-918-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty