Provider Demographics
NPI:1811024466
Name:HARMON CHIROPRACTIC INC
Entity Type:Organization
Organization Name:HARMON CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:859-986-5636
Mailing Address - Street 1:327 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1921
Mailing Address - Country:US
Mailing Address - Phone:859-986-5636
Mailing Address - Fax:
Practice Address - Street 1:327 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1921
Practice Address - Country:US
Practice Address - Phone:859-986-5636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8500205300Medicaid
KY8500205300Medicaid
U50296Medicare UPIN