Provider Demographics
NPI:1538369814
Name:CHALKE CHIROPRACTIC PSC
Entity type:Organization
Organization Name:CHALKE CHIROPRACTIC PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:CHALKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-442-3988
Mailing Address - Street 1:131 NAHM ST STE 5
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-4362
Mailing Address - Country:US
Mailing Address - Phone:270-442-3988
Mailing Address - Fax:
Practice Address - Street 1:131 NAHM ST STE 5
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4362
Practice Address - Country:US
Practice Address - Phone:270-442-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYU91680Medicare UPIN