Provider Demographics
NPI:1548471659
Name:AMBER BLANTON-MCCALVIN CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:AMBER BLANTON-MCCALVIN CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:BLANTON-MCCALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-932-2414
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:
Mailing Address - City:SOUTH SHORE
Mailing Address - State:KY
Mailing Address - Zip Code:41175-0022
Mailing Address - Country:US
Mailing Address - Phone:606-932-2414
Mailing Address - Fax:606-932-2421
Practice Address - Street 1:28350 U.S. 23
Practice Address - Street 2:
Practice Address - City:SOUTH SHORE
Practice Address - State:KY
Practice Address - Zip Code:41175
Practice Address - Country:US
Practice Address - Phone:606-932-2414
Practice Address - Fax:606-932-2421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty