Healthcare Provider Details

I. General information

NPI: 1720721129
Provider Name (Legal Business Name): ACUPUNCTURENKY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BUTTERMILK PIKE
CRESCENT SPRINGS KY
41017-1310
US

IV. Provider business mailing address

747 BUTTERMILK PIKE
CRESCENT SPRINGS KY
41017-1310
US

V. Phone/Fax

Practice location:
  • Phone: 859-586-0111
  • Fax: 859-242-7008
Mailing address:
  • Phone: 859-586-0111
  • Fax: 859-242-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTI A GROGAN
Title or Position: OWNER
Credential: PRESIDENT
Phone: 859-802-9770