BRADLEY A. TACK P.S.C. NPI 1003969460

NPI Information

NPI: 1003969460
Provider Name: BRADLEY A. TACK P.S.C.

Doing Business As: CALVERT CITY CHIROPRACTIC

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
5131 US HIGHWAY 62
CALVERT CITY, KY
ZIP 42029
Phone: (270) 395-4540
Get Directions

BRADLEY A. TACK P.S.C. is a chiropractor in Calvert City, KY. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. BRADLEY A. TACK P.S.C. NPI is 1003969460. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Calvert City Chiropractic.

The provider's business location address is:

5131 US HIGHWAY 62
CALVERT CITY, KY
ZIP 42029-390
Phone: (270) 395-4540
Fax: (270) 395-7715

The provider's authorized official is Bradley A. Tack .
The authorized official title is Owner and has the following contact phone number (270) 395-4540.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	85900181	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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