Provider Demographics
NPI:1316142847
Name:GEORGE SHIRAR, DC, PSC
Entity type:Organization
Organization Name:GEORGE SHIRAR, DC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-254-5001
Mailing Address - Street 1:1057 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2644
Mailing Address - Country:US
Mailing Address - Phone:859-254-5001
Mailing Address - Fax:859-255-3248
Practice Address - Street 1:1057 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2644
Practice Address - Country:US
Practice Address - Phone:859-254-5001
Practice Address - Fax:859-255-3248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty