Provider Demographics
NPI:1982863049
Name:SCHWEITZER CHIROPRACTIC
Entity Type:Organization
Organization Name:SCHWEITZER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-441-8800
Mailing Address - Street 1:20 N GRAND AVE
Mailing Address - Street 2:SUITE 12 SCHWEITZER CHIROPRACTIC
Mailing Address - City:FT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075
Mailing Address - Country:US
Mailing Address - Phone:859-441-8800
Mailing Address - Fax:859-441-8813
Practice Address - Street 1:20 N GRAND AVE
Practice Address - Street 2:SUITE 12 SCHWEITZER CHIROPRACTIC
Practice Address - City:FT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075
Practice Address - Country:US
Practice Address - Phone:859-441-8800
Practice Address - Fax:859-441-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000373563OtherANTHEM
KY85041507Medicaid
U51920Medicare PIN
000000373563OtherANTHEM