Provider Demographics
NPI:1457479594
Name:KING CHIROPRACTIC OF FLORENCE KY PSC
Entity Type:Organization
Organization Name:KING CHIROPRACTIC OF FLORENCE KY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-525-1213
Mailing Address - Street 1:8 YOUELL ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2019
Mailing Address - Country:US
Mailing Address - Phone:859-525-1213
Mailing Address - Fax:859-525-4016
Practice Address - Street 1:8 YOUELL ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2019
Practice Address - Country:US
Practice Address - Phone:859-525-1213
Practice Address - Fax:859-525-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85900231Medicaid
KY85900231Medicaid