Provider Demographics
NPI:1780798330
Name:E TOWN CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:E TOWN CHIROPRACTIC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESDENT MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:TINDALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ND, DCP, DABCO
Authorized Official - Phone:270-769-9844
Mailing Address - Street 1:620 WESTPORT RD STE A
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4408
Mailing Address - Country:US
Mailing Address - Phone:270-769-9844
Mailing Address - Fax:270-769-2205
Practice Address - Street 1:620 WESTPORT RD STE A
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4408
Practice Address - Country:US
Practice Address - Phone:270-769-9844
Practice Address - Fax:270-769-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4102111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty