Healthcare Provider Details

I. General information

NPI: 1578508719
Provider Name (Legal Business Name): TOMPKINSVILLE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 4TH ST
TOMPKINSVILLE KY
42167-1611
US

IV. Provider business mailing address

200 E 4TH ST
TOMPKINSVILLE KY
42167-1611
US

V. Phone/Fax

Practice location:
  • Phone: 270-487-6254
  • Fax: 270-487-1462
Mailing address:
  • Phone: 270-487-6254
  • Fax: 270-487-1462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4981
License Number StateKY

VIII. Authorized Official

Name: DR. NICK POYNTER
Title or Position: D.C.
Credential: D.C.
Phone: 270-487-6254