Provider Demographics
NPI:1770673857
Name:KNOPP&FLYNN CHIROPRACTIC CENTER PSC
Entity Type:Organization
Organization Name:KNOPP&FLYNN CHIROPRACTIC CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-955-5328
Mailing Address - Street 1:1451 HIGHWAY 44 E
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-5128
Mailing Address - Country:US
Mailing Address - Phone:502-955-6328
Mailing Address - Fax:502-543-5039
Practice Address - Street 1:1451 HIGHWAY 44 E
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-5128
Practice Address - Country:US
Practice Address - Phone:502-955-6328
Practice Address - Fax:502-543-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6066301Medicare ID - Type Unspecified