Provider Demographics
NPI:1104015593
Name:PRECISION CHIROPRACTIC CENTER, PSC
Entity Type:Organization
Organization Name:PRECISION CHIROPRACTIC CENTER, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-365-0203
Mailing Address - Street 1:109 LILY DR.
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484
Mailing Address - Country:US
Mailing Address - Phone:606-365-0203
Mailing Address - Fax:606-365-0208
Practice Address - Street 1:109 LILY DR.
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484
Practice Address - Country:US
Practice Address - Phone:606-365-0203
Practice Address - Fax:606-365-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001279Medicaid
KY0943901Medicare PIN
KY85001279Medicaid