Provider Demographics
NPI:1194348433
Name:FOUNDATION CHIRO PSC
Entity type:Organization
Organization Name:FOUNDATION CHIRO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-648-5446
Mailing Address - Street 1:PO BOX 572
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:KY
Mailing Address - Zip Code:40050-0572
Mailing Address - Country:US
Mailing Address - Phone:502-667-6527
Mailing Address - Fax:
Practice Address - Street 1:112 COURT ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW CASTLE
Practice Address - State:KY
Practice Address - Zip Code:40050
Practice Address - Country:US
Practice Address - Phone:502-667-6527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100195450Medicaid
KYP400039521OtherMEDICARE PIN