Healthcare Provider Details

I. General information

NPI: 1013642198
Provider Name (Legal Business Name): NEW BEGINNINGS CHIROPRACTIC OF WILLISBURG PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2084 MAIN ST
WILLISBURG KY
40078-8199
US

IV. Provider business mailing address

PO BOX 2257
DANVILLE KY
40423-2257
US

V. Phone/Fax

Practice location:
  • Phone: 859-374-1479
  • Fax: 859-239-0044
Mailing address:
  • Phone: 859-374-1479
  • Fax: 859-239-0044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: CALLIE SHORT
Title or Position: OWNER
Credential: DC
Phone: 859-583-3842