Provider Demographics
NPI:1992126882
Name:CHIROPRACTIC COMPLIANCE CONSULTING LLC
Entity type:Organization
Organization Name:CHIROPRACTIC COMPLIANCE CONSULTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:MACK
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-272-0002
Mailing Address - Street 1:2121 RICHMOND RD
Mailing Address - Street 2:SUITE115
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1206
Mailing Address - Country:US
Mailing Address - Phone:859-272-0002
Mailing Address - Fax:859-264-0916
Practice Address - Street 1:2121 RICHMOND RD
Practice Address - Street 2:SUITE115
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1206
Practice Address - Country:US
Practice Address - Phone:859-272-0002
Practice Address - Fax:859-264-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100074310Medicaid
KYK101640Medicare PIN