Provider Demographics
NPI:1588863468
Name:APPALACHIAN CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:APPALACHIAN CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:KRICKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-639-4440
Mailing Address - Street 1:510 JUSTIS DR
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4287
Mailing Address - Country:US
Mailing Address - Phone:423-639-4440
Mailing Address - Fax:423-639-0023
Practice Address - Street 1:510 JUSTIS DR
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4287
Practice Address - Country:US
Practice Address - Phone:423-639-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3731787Medicare PIN