Provider Demographics
NPI:1184832214
Name:HARRODSBURG CHIROPRACTIC, P.S.C.
Entity Type:Organization
Organization Name:HARRODSBURG CHIROPRACTIC, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-734-9992
Mailing Address - Street 1:584 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-2401
Mailing Address - Country:US
Mailing Address - Phone:859-734-9992
Mailing Address - Fax:859-734-9929
Practice Address - Street 1:584 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-2401
Practice Address - Country:US
Practice Address - Phone:859-734-9992
Practice Address - Fax:859-734-9929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty