Organization
ACTIVE BODY CHIROPRACTIC AND INJURY CENTER PLLC
Active
Other names
Family Chiropractic of Harrodsburg
Organization subpart
No
Provider details
NPI number
Authorized official
TOSHA MCCORMACK (COMPLIANCE OFFICER)
(859) 408-5440
Entity
Organization
Contact information
Practice address
507 JOSEPH DR., STE. 4, HARRODSBURG, KY 40330
(859) 734-2800
(859) 734-2805
Mailing address
507 JOSEPH DR., STE. 4, HARRODSBURG, KY 40330
(859) 734-2800
(859) 734-2805
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00759001
MEDICARE PTIN
KY
05
—
7100293130
—
KY
Enumeration date
12/19/2007
Last updated
10/06/2022
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