Provider Demographics
NPI:1124209002
Name:QFOUR, INC.
Entity Type:Organization
Organization Name:QFOUR, INC.
Other - Org Name:FAMILY CARE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNELLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-937-7995
Mailing Address - Street 1:10110 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-3948
Mailing Address - Country:US
Mailing Address - Phone:502-937-7995
Mailing Address - Fax:
Practice Address - Street 1:10110 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-3948
Practice Address - Country:US
Practice Address - Phone:502-937-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50007023Medicaid
KY7096Medicare PIN