Provider Demographics
NPI:1669800660
Name:PICKENS COUNTY CHIROPRACTIC
Entity type:Organization
Organization Name:PICKENS COUNTY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-253-4243
Mailing Address - Street 1:95 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-1503
Mailing Address - Country:US
Mailing Address - Phone:706-253-4243
Mailing Address - Fax:
Practice Address - Street 1:95 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143
Practice Address - Country:US
Practice Address - Phone:706-253-4243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty