MEDICARE: FLOREK FAMILY CHIROPRACTIC LLC

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	:	1245798198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOREK FAMILY CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	725 ALEXANDRIA PIKE STE 240
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2169
Country	:	US
Telephone Number	:	859-441-6100
Fax Number	:	859-441-6300

Provider Business Practice Location Address
First Line	:	725 ALEXANDRIA PIKE STE 240
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2169
Country	:	US
Telephone Number	:	859-441-6100
Fax Number	:	859-441-6300

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUSTIN WILLIAM FLOREK
Credential	:	DC
Telephone Number	:	859-441-6100

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	03/11/2019

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