Provider Demographics
NPI:1841669397
Name:MERIDIAN CHIROPRACTIC
Entity type:Organization
Organization Name:MERIDIAN CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-307-8779
Mailing Address - Street 1:11091 CLAY DR
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-7473
Mailing Address - Country:US
Mailing Address - Phone:859-918-6868
Mailing Address - Fax:859-317-5781
Practice Address - Street 1:11091 CLAY DR
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:KY
Practice Address - Zip Code:41094-7473
Practice Address - Country:US
Practice Address - Phone:859-918-6868
Practice Address - Fax:859-317-5781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty