Provider Demographics
NPI:1316195100
Name:BODY WORKS CHIROPRACTIC PSC
Entity Type:Organization
Organization Name:BODY WORKS CHIROPRACTIC PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRUMLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-904-2639
Mailing Address - Street 1:2965 N MILL AVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-6304
Mailing Address - Country:US
Mailing Address - Phone:270-904-2639
Mailing Address - Fax:270-904-0815
Practice Address - Street 1:2965 N MILL AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-6304
Practice Address - Country:US
Practice Address - Phone:270-904-2639
Practice Address - Fax:270-904-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty