Provider Demographics
NPI:1750494993
Name:HEALTHY TRENDS PSC
Entity Type:Organization
Organization Name:HEALTHY TRENDS PSC
Other - Org Name:SPRINGFIELD CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELWYN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:LOUGHNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-336-7000
Mailing Address - Street 1:1113 LINCOLN PARK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069-9573
Mailing Address - Country:US
Mailing Address - Phone:859-336-7000
Mailing Address - Fax:859-336-9882
Practice Address - Street 1:1113 LINCOLN PARK RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069-9573
Practice Address - Country:US
Practice Address - Phone:859-336-7000
Practice Address - Fax:859-336-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5283111N00000X, 261Q00000X
KY4970261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00074Medicare PIN
KY00074001Medicare PIN
KYV04672Medicare UPIN
KY00074Medicare PIN
V04672Medicare UPIN
00074001Medicare PIN