Provider Demographics
NPI:1578882536
Name:CHIRO ONE WELLNESS CENTER OF GEORGETOWN PLLC
Entity Type:Organization
Organization Name:CHIRO ONE WELLNESS CENTER OF GEORGETOWN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-831-4432
Mailing Address - Street 1:3738 SOLUTIONS CTR
Mailing Address - Street 2:#773738
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-0001
Mailing Address - Country:US
Mailing Address - Phone:606-831-4432
Mailing Address - Fax:859-264-8081
Practice Address - Street 1:108 OSBOURNE WAY
Practice Address - Street 2:SUITE 6
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9693
Practice Address - Country:US
Practice Address - Phone:606-831-4432
Practice Address - Fax:502-867-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty