Provider Demographics
NPI:1376579011
Name:ANGELOPOULOS CHIROPRACTIC PROF. CORP.
Entity Type:Organization
Organization Name:ANGELOPOULOS CHIROPRACTIC PROF. CORP.
Other - Org Name:DESERT CITIES CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ATHANASIA
Authorized Official - Middle Name:ANASTASIA
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:2006-06-24
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29712111N00000X
CADC 32157111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty