Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 249326 | KY |
Y | 111NS0005X | Chiropractic Sports Physician | 249326 | KY |
NPI | 1205074978 |
---|---|
Provider Name | Dr. Chad Alan Folk |
First Address | Bowling Green, KY 42102-2050 |
Second Address | Bowling Green, KY 42101-1703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 29/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100162070 | (05) | KY |
7100338130 | (05) | KY |