Provider Demographics
NPI:1083051882
Name:BETTINGER CHIROPRACTIC CENTER, PLLC
Entity Type:Organization
Organization Name:BETTINGER CHIROPRACTIC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-759-0090
Mailing Address - Street 1:497 TUCKER DR
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-9111
Mailing Address - Country:US
Mailing Address - Phone:606-759-0090
Mailing Address - Fax:606-759-0092
Practice Address - Street 1:497 TUCKER DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9111
Practice Address - Country:US
Practice Address - Phone:606-759-0090
Practice Address - Fax:606-759-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3075587Medicaid