Provider Demographics
NPI:1023295219
Name:QUALLS FAMILY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:QUALLS FAMILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/D.C.
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:QUALLS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-473-2132
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-0577
Mailing Address - Country:US
Mailing Address - Phone:606-473-2132
Mailing Address - Fax:
Practice Address - Street 1:1629 ASHLAND RD STE 4
Practice Address - Street 2:
Practice Address - City:GREENUP
Practice Address - State:KY
Practice Address - Zip Code:41144-1249
Practice Address - Country:US
Practice Address - Phone:606-473-2132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center