MEDICARE: GEORGETOWN CHIROPRACTIC CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1053973644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGETOWN CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	1304 PARIS PIKE
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-9704
Country	:	US
Telephone Number	:	502-735-0707
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 PARIS PIKE
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-9704
Country	:	US
Telephone Number	:	859-242-9469
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. AMANDA HOWELL WINTERS
Credential	:	DC
Telephone Number	:	502-735-0707

Provider Enumeration Date	:	07/03/2019
Last Update Date	:	07/16/2019

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Directions to “GEORGETOWN CHIROPRACTIC CENTER ” Practice Location

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