Provider Demographics
NPI:1629392212
Name:KACHINSKY FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KACHINSKY FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-607-5428
Mailing Address - Street 1:PO BOX 2795
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-1697
Mailing Address - Country:US
Mailing Address - Phone:770-607-5428
Mailing Address - Fax:770-607-9638
Practice Address - Street 1:607 N TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2824
Practice Address - Country:US
Practice Address - Phone:770-607-5428
Practice Address - Fax:770-607-9638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8029305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJSSMedicare UPIN