Provider Demographics
NPI:1750789673
Name:DALE HOLLOW CHIROPRACTIC PSC
Entity type:Organization
Organization Name:DALE HOLLOW CHIROPRACTIC PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANNAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-864-1774
Mailing Address - Street 1:PO BOX 294
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-0294
Mailing Address - Country:US
Mailing Address - Phone:270-864-1774
Mailing Address - Fax:801-820-3309
Practice Address - Street 1:390 KEEN ST
Practice Address - Street 2:
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717-7682
Practice Address - Country:US
Practice Address - Phone:270-433-3149
Practice Address - Fax:801-820-3309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY5153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty