Provider Demographics
NPI:1962658757
Name:QUALITY CHIROPRACTIC, PSC
Entity Type:Organization
Organization Name:QUALITY CHIROPRACTIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SONNI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-780-7400
Mailing Address - Street 1:547A WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351
Mailing Address - Country:US
Mailing Address - Phone:606-780-7400
Mailing Address - Fax:606-783-0994
Practice Address - Street 1:547A WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351
Practice Address - Country:US
Practice Address - Phone:606-780-7400
Practice Address - Fax:606-783-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85000917Medicaid
KY85000917Medicaid