Healthcare Provider Details
I. General information
NPI: 1174727465
Provider Name (Legal Business Name): COMPLETE CHIROPRACTIC OF COVINGTON
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2007
Last Update Date: 12/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
638 MAIN ST
COVINGTON KY
41011-1653
US
IV. Provider business mailing address
146 BURDSALL AVE
FORT MITCHELL KY
41017-2826
US
V. Phone/Fax
- Phone: 859-261-9261
- Fax: 859-261-9262
- Phone: 859-578-0825
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 4320 |
| License Number State | KY |
VIII. Authorized Official
Name: DR.
DEBRA
KAY
SAVIGNANO
Title or Position: PRESIDENT - CHIROPRACTOR
Credential: D.C.
Phone: 859-261-9261