Provider Demographics
NPI:1083860068
Name:SUNRISE CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:SUNRISE CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCCASLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-625-9791
Mailing Address - Street 1:966 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3402
Mailing Address - Country:US
Mailing Address - Phone:859-625-9791
Mailing Address - Fax:859-625-7840
Practice Address - Street 1:966 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3402
Practice Address - Country:US
Practice Address - Phone:859-625-9791
Practice Address - Fax:859-625-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3991111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYKY 3991OtherKY WORKERS COMP
KY85001188Medicaid
KY44-00050OtherUNITED HEALTHCARE
KY000000050248OtherANTHEM BC/BS
KY607191OtherACN GROUP BLUEGRASS FAMILY HEALTH
KY85001188Medicaid
KY44-00050OtherUNITED HEALTHCARE