Provider Demographics
NPI:1649467432
Name:FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARMSTONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-348-7111
Mailing Address - Street 1:1315 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2618
Mailing Address - Country:US
Mailing Address - Phone:502-348-7111
Mailing Address - Fax:502-348-7178
Practice Address - Street 1:1315 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2618
Practice Address - Country:US
Practice Address - Phone:502-348-7111
Practice Address - Fax:502-348-7178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7005136OtherAETNA
KY1123919OtherPASSPORT HEALTH PLAN
KY5633450OtherFIRST HEALTH
KY000000298359OtherBLUE CROSS BLUE SHIELD
KY1218547OtherCHA HEALTH
KY2437278000OtherPASSPORT ADVANTAGE
KY85003119Medicaid
KY000000298359OtherBLUE CROSS BLUE SHIELD
KY1123919OtherPASSPORT HEALTH PLAN