Healthcare Provider Details

I. General information

NPI: 1700957131
Provider Name (Legal Business Name): KENNNETH RAY PRICE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 ADAMS ST
DANVILLE KY
40422-1901
US

IV. Provider business mailing address

105 FOX CHASE
DANVILLE KY
40422-8965
US

V. Phone/Fax

Practice location:
  • Phone: 859-236-0202
  • Fax: 859-236-0102
Mailing address:
  • Phone: 859-854-3555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5017
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: