| Phaup Chiropractic Center, Llc | |
|
1015 College Dr Madisonville KY 42431-9189 | |
| (270) 452-2187 | |
| Not Available |
| Full Name | Phaup Chiropractic Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1015 College Dr, Madisonville, Kentucky |
| Authorized Official Name and Position | Amber Long (OFFICE MANAGER) |
| Authorized Official Contact | 2704522187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phaup Chiropractic Center, Llc 1015 College Dr Madisonville KY 42431-9189 Ph: (270) 452-2187 | Phaup Chiropractic Center, Llc 1015 College Dr Madisonville KY 42431-9189 Ph: (270) 452-2187 |
| NPI Number | 1245747674 |
|---|---|
| Provider Enumeration Date | 01/08/2018 |
| Last Update Date | 05/26/2021 |
| Medicare PECOS PAC ID | 1759640147 |
|---|---|
| Medicare Enrollment ID | O20180110000944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245747674 | NPI | - | NPPES |
| 1578935920 | Other | KY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5477 (Kentucky) | Primary |
| Provider Name | Kyle Phaup |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578935920 PECOS PAC ID: 6103185509 Enrollment ID: I20180130000057 |
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