Provider Demographics
NPI:1346978533
Name:AXIS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:AXIS CHIROPRACTIC LLC
Other - Org Name:AXIS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-901-8353
Mailing Address - Street 1:3775 HALEY DR STE C
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-2642
Mailing Address - Country:US
Mailing Address - Phone:812-629-2028
Mailing Address - Fax:
Practice Address - Street 1:3775 HALEY DR STE C
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2642
Practice Address - Country:US
Practice Address - Phone:812-629-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY276952OtherKENTUCKY BOARD OF CHIROPRACTIC EXAMINERS
IN08003194AOtherINDIANA BOARD OF CHIROPRACTIC EXAMINERS