Provider Demographics
NPI:1043489578
Name:PRANGE CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:PRANGE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-564-0732
Mailing Address - Street 1:2846 US HIGHWAY 95
Mailing Address - Street 2:
Mailing Address - City:CALVERT CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42029-8853
Mailing Address - Country:US
Mailing Address - Phone:270-564-0732
Mailing Address - Fax:
Practice Address - Street 1:3098 US HIGHWAY 641 N
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-7464
Practice Address - Country:US
Practice Address - Phone:270-527-7033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4995111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty