Provider Demographics
NPI:1699260406
Name:CARROLL COUNTY CHIROPRACTIC AND REHABILITATION LLC
Entity type:Organization
Organization Name:CARROLL COUNTY CHIROPRACTIC AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MASSIMO
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-962-2277
Mailing Address - Street 1:2519 HWY 227 UNIT D
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:KY
Mailing Address - Zip Code:41008-1189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2519 HWY 227 UNIT D
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-1189
Practice Address - Country:US
Practice Address - Phone:502-519-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty