Provider Demographics
NPI:1104015270
Name:TRUE FAMILY CHIROPRACTIC, PSC
Entity Type:Organization
Organization Name:TRUE FAMILY CHIROPRACTIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TRUE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-866-7246
Mailing Address - Street 1:262 E STEVE WARINER DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-4225
Mailing Address - Country:US
Mailing Address - Phone:270-866-7246
Mailing Address - Fax:270-866-7266
Practice Address - Street 1:262 E STEVE WARINER DR
Practice Address - Street 2:
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642-4225
Practice Address - Country:US
Practice Address - Phone:270-866-7246
Practice Address - Fax:270-866-7266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85003648Medicaid
KY9705Medicare PIN