Provider Demographics
NPI:1508042953
Name:HART CHIROPRACTIC CENTER PLLC
Entity Type:Organization
Organization Name:HART CHIROPRACTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:VARONA
Authorized Official - Last Name:RATUSNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-786-4546
Mailing Address - Street 1:115 WATER ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:HORSE CAVE
Mailing Address - State:KY
Mailing Address - Zip Code:42749-1282
Mailing Address - Country:US
Mailing Address - Phone:270-786-4546
Mailing Address - Fax:270-786-4037
Practice Address - Street 1:115 WATER ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:HORSE CAVE
Practice Address - State:KY
Practice Address - Zip Code:42749-1282
Practice Address - Country:US
Practice Address - Phone:270-786-4546
Practice Address - Fax:270-786-4037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4813111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85002806Medicaid
KY000000390128OtherANTHEM
KYDD1554OtherMEDICARE RAILROAD GROUP
KYU96853OtherUPIN
KY8889OtherMEDICARE GROUP
KYP00211313OtherMEDICARE RAILROAD INDIVID
KY85002806Medicaid