Provider Demographics
NPI:1902037591
Name:BELL CHIROPRACTIC SERVICES LLC
Entity Type:Organization
Organization Name:BELL CHIROPRACTIC SERVICES LLC
Other - Org Name:GEORGETOWN CHIROPRACTIC CENTER LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-321-9503
Mailing Address - Street 1:107 FRAZIER CT
Mailing Address - Street 2:#1B
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8973
Mailing Address - Country:US
Mailing Address - Phone:502-867-0807
Mailing Address - Fax:502-867-0903
Practice Address - Street 1:107 FRAZIER CT
Practice Address - Street 2:#1B
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8973
Practice Address - Country:US
Practice Address - Phone:502-867-0807
Practice Address - Fax:502-867-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100091710Medicaid
KY01105001Medicare PIN