Provider Demographics
NPI:1164612701
Name:SCHWARTZ CHIROPRACTIC CENTER, PLLC
Entity Type:Organization
Organization Name:SCHWARTZ CHIROPRACTIC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-466-5940
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:OWENTON
Mailing Address - State:KY
Mailing Address - Zip Code:40359-0069
Mailing Address - Country:US
Mailing Address - Phone:502-484-2319
Mailing Address - Fax:502-484-0841
Practice Address - Street 1:106 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OWENTON
Practice Address - State:KY
Practice Address - Zip Code:40359-1431
Practice Address - Country:US
Practice Address - Phone:502-484-2319
Practice Address - Fax:502-484-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4249111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6434Medicare PIN