Provider Demographics
NPI:1699956615
Name:CALLOWAY COUNTY CHIROPRACTIC, PSC
Entity type:Organization
Organization Name:CALLOWAY COUNTY CHIROPRACTIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-753-6100
Mailing Address - Street 1:PO BOX 1042
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-0018
Mailing Address - Country:US
Mailing Address - Phone:270-753-6100
Mailing Address - Fax:270-767-9490
Practice Address - Street 1:1710D HWY 121 NORTH BYPASS
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:270-753-6100
Practice Address - Fax:270-767-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6255760001Medicare NSC
KY9176Medicare PIN