Provider Demographics
NPI:1760117543
Name:AMERINE CHIROPRACTIC SERVICES PLLC
Entity Type:Organization
Organization Name:AMERINE CHIROPRACTIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-278-9242
Mailing Address - Street 1:169 BURT RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2455
Mailing Address - Country:US
Mailing Address - Phone:859-278-9242
Mailing Address - Fax:859-277-0240
Practice Address - Street 1:692 TETON TRL
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-1766
Practice Address - Country:US
Practice Address - Phone:563-506-2723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty