Provider Demographics
NPI:1265474902
Name:MERCER CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:MERCER CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:K
Authorized Official - Last Name:NOCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-734-7646
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-0252
Mailing Address - Country:US
Mailing Address - Phone:859-734-7646
Mailing Address - Fax:859-734-7651
Practice Address - Street 1:999 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1083
Practice Address - Country:US
Practice Address - Phone:859-734-7646
Practice Address - Fax:859-734-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5297721OtherAETNA
KY85002566Medicaid
KY607720OtherACN
KY000000066774OtherANTHEM
KYT834OtherANTHEM
KY5297721OtherAETNA
KY607720OtherACN