Provider Demographics
NPI:1225850324
Name:KY CHIROPRACTIC MT STERLING
Entity type:Organization
Organization Name:KY CHIROPRACTIC MT STERLING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASSITY
Authorized Official - Middle Name:SHANTEL
Authorized Official - Last Name:WOOLUMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-954-2491
Mailing Address - Street 1:420 E MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1649
Mailing Address - Country:US
Mailing Address - Phone:859-432-1007
Mailing Address - Fax:859-432-1008
Practice Address - Street 1:420 E MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1649
Practice Address - Country:US
Practice Address - Phone:859-432-1007
Practice Address - Fax:859-432-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty