Healthcare Provider Details

I. General information

NPI: 1194332338
Provider Name (Legal Business Name): CORE HEALTH CENTERS OF DRY RIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 FASHION RIDGE RD
DRY RIDGE KY
41035-9609
US

IV. Provider business mailing address

1113 FASHION RIDGE RD
DRY RIDGE KY
41035-9609
US

V. Phone/Fax

Practice location:
  • Phone: 606-831-4432
  • Fax: 859-643-6100
Mailing address:
  • Phone: 606-831-4432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JEREMIAH HOLMES
Title or Position: OWNER
Credential: DC
Phone: 859-643-6100