Provider Demographics
NPI:1477556884
Name:SALYERS, CHARLES R II (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:R
Last Name:SALYERS
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 KY ROUTE 321
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9102
Mailing Address - Country:US
Mailing Address - Phone:606-889-9222
Mailing Address - Fax:606-886-1605
Practice Address - Street 1:1827 KY ROUTE 321
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9102
Practice Address - Country:US
Practice Address - Phone:606-889-9222
Practice Address - Fax:606-886-1605
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2013-07-30
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
KY4265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1477556884Medicaid
KY1326111071Medicaid
KY85036358Medicaid
KYU57290Medicare UPIN
KY1477556884Medicare NSC
KY1477556884Medicaid