Provider Demographics
NPI:1487061594
Name:EDEARINGER & KLINDT CHIROPRACTIC CARE CNETER
Entity type:Organization
Organization Name:EDEARINGER & KLINDT CHIROPRACTIC CARE CNETER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARTLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLINDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-348-3202
Mailing Address - Street 1:107 N. 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004
Mailing Address - Country:US
Mailing Address - Phone:502-348-3202
Mailing Address - Fax:502-348-0321
Practice Address - Street 1:107 N 5TH ST
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1401
Practice Address - Country:US
Practice Address - Phone:502-348-3202
Practice Address - Fax:502-348-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
4520332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001287Medicaid
KY85001287Medicaid
KY6087802Medicare PIN