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General NPI Number Information
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NPI Number | 1568668499
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Entity Type | Organization
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Legal Business Name | AMERICAN CHIROPRACTIC WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 03/22/2019
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Provider Practice Location Address
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Address Line | 2902 DOLPHIN DR
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7102
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Country | US
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Telephone | 270-769-2255
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Fax | 270-763-9773
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Provider Business Mailing Address
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Address Line | 519 B NORTH MILES SUITE 103
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7945
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Country | US
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Telephone | 270-769-2255
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Fax | 270-763-9773
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG ALAN BARTELT
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Credential | D.C.
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Telephone | 270-769-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4628
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License Number State | KY
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