Provider Demographics
NPI:1396905378
Name:ORCHARD CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:ORCHARD CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEATING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-887-1855
Mailing Address - Street 1:100 JOHN SUTHERLAND DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2424
Mailing Address - Country:US
Mailing Address - Phone:859-887-1855
Mailing Address - Fax:
Practice Address - Street 1:100 JOHN SUTHERLAND DR
Practice Address - Street 2:SUITE 1
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2424
Practice Address - Country:US
Practice Address - Phone:859-887-1855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty