Provider Demographics
NPI:1609063981
Name:BURGETT, PSC
Entity Type:Organization
Organization Name:BURGETT, PSC
Other - Org Name:BARDSTOWN CHIROPRACTIC PAIN & INJURY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BEN
Authorized Official - Last Name:BURGETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-331-0301
Mailing Address - Street 1:1015 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2616
Mailing Address - Country:US
Mailing Address - Phone:502-331-0301
Mailing Address - Fax:502-331-0301
Practice Address - Street 1:1015 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2616
Practice Address - Country:US
Practice Address - Phone:502-331-0301
Practice Address - Fax:502-331-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4639261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center