Healthcare Provider Details

I. General information

NPI: 1679666143
Provider Name (Legal Business Name): RODGER ALLEN LINDSEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 MOHAWK STREET
BROWNSVILLE KY
42210-0479
US

IV. Provider business mailing address

PO BOX 479
BROWNSVILLE KY
42210-0479
US

V. Phone/Fax

Practice location:
  • Phone: 270-597-9024
  • Fax: 270-597-9024
Mailing address:
  • Phone: 270-597-9024
  • Fax: 270-597-9024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3915
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1247
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberKY-0933
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: