Provider Demographics
NPI:1194456368
Name:ATHANASIA ANGELOPOULOS, DC
Entity Type:Organization
Organization Name:ATHANASIA ANGELOPOULOS, DC
Other - Org Name:PATRIOT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ATHANASIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANGELOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-352-7171
Mailing Address - Street 1:5 PHYSICIANS PARK STE 4
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4163
Mailing Address - Country:US
Mailing Address - Phone:502-352-7171
Mailing Address - Fax:502-352-9514
Practice Address - Street 1:5 PHYSICIANS PARK STE 4
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4163
Practice Address - Country:US
Practice Address - Phone:502-352-7171
Practice Address - Fax:502-352-9514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty