Provider Demographics
NPI:1588805733
Name:TRG INVESTMENTS LLC
Entity Type:Organization
Organization Name:TRG INVESTMENTS LLC
Other - Org Name:WESTERN KENTUCKY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
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:270-904-3499
Mailing Address - Street 1:1256 CAMPBELL LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-1082
Mailing Address - Country:US
Mailing Address - Phone:270-904-3499
Mailing Address - Fax:270-904-3472
Practice Address - Street 1:1256 CAMPBELL LN
Practice Address - Street 2:SUITE 103
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-1082
Practice Address - Country:US
Practice Address - Phone:270-904-3499
Practice Address - Fax:270-904-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
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
KY6103101OtherMEDICARE INDIVIDUAL
KY000000390128OtherANTHEM BLUE CROSS BLUE SHIELD
KY8889OtherMEDICARE GROUP