Provider Demographics
NPI:1609020635
Name:SYNERGY CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:SYNERGY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:W
Authorized Official - Last Name:ORNBURN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-442-0999
Mailing Address - Street 1:1412 GLORIA TERRELL DRIVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WILDER
Mailing Address - State:KY
Mailing Address - Zip Code:41076
Mailing Address - Country:US
Mailing Address - Phone:859-442-0999
Mailing Address - Fax:
Practice Address - Street 1:1412 GLORIA TERRELL DR STE 4
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076-9102
Practice Address - Country:US
Practice Address - Phone:859-442-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5137111N00000X
KY5136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty