Provider Demographics
NPI:1609392026
Name:COLASANTI CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:COLASANTI CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:COLASANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-706-4181
Mailing Address - Street 1:2626 RING RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-9118
Mailing Address - Country:US
Mailing Address - Phone:270-706-4181
Mailing Address - Fax:
Practice Address - Street 1:2626 RING RD STE 102
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9118
Practice Address - Country:US
Practice Address - Phone:270-765-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty