Provider Demographics
NPI:1780782045
Name:BIERLY FAMILY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:BIERLY FAMILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BIERLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-859-9075
Mailing Address - Street 1:236 E WOODFORD ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-1144
Mailing Address - Country:US
Mailing Address - Phone:502-859-9075
Mailing Address - Fax:502-859-9076
Practice Address - Street 1:236 E WOODFORD ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-1144
Practice Address - Country:US
Practice Address - Phone:502-859-9075
Practice Address - Fax:502-859-9076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100032590Medicaid
KYDG7301OtherRAILROAD MEDICARE
KY85001139Medicaid
KYDG7301OtherRAILROAD MEDICARE