Provider Demographics
NPI:1699842088
Name:BYERS-ABSTON CHIROPRACTIC, PSC
Entity Type:Organization
Organization Name:BYERS-ABSTON CHIROPRACTIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERS-ABSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-426-6715
Mailing Address - Street 1:105 N. LYNDON LANE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5550
Mailing Address - Country:US
Mailing Address - Phone:502-426-6715
Mailing Address - Fax:502-426-6716
Practice Address - Street 1:105 N. LYNDON LANE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5550
Practice Address - Country:US
Practice Address - Phone:502-426-6715
Practice Address - Fax:502-426-6716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3737305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100018000Medicaid
KY000000534733OtherANTHEM
KY000000534733OtherANTHEM
00248Medicare PIN