Provider Demographics
NPI:1174945091
Name:MIDDLETOWN FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:MIDDLETOWN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:TAMMINGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-253-6770
Mailing Address - Street 1:12334 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1471
Mailing Address - Country:US
Mailing Address - Phone:502-253-6770
Mailing Address - Fax:502-253-6772
Practice Address - Street 1:12334 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:KY
Practice Address - Zip Code:40243-1471
Practice Address - Country:US
Practice Address - Phone:502-253-6770
Practice Address - Fax:502-253-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty