Provider Demographics
NPI:1649276361
Name:BAER CHIROPRACTIC INC
Entity type:Organization
Organization Name:BAER CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-479-9885
Mailing Address - Street 1:2240 TAYLORSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2146
Mailing Address - Country:US
Mailing Address - Phone:502-479-9885
Mailing Address - Fax:502-479-9875
Practice Address - Street 1:2240 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2146
Practice Address - Country:US
Practice Address - Phone:502-479-9885
Practice Address - Fax:502-479-9875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000354203OtherANTHEM
KY000000354203OtherANTHEM