Healthcare Provider Details

I. General information

NPI: 1417356767
Provider Name (Legal Business Name): ADJUSTED, INC - CHIROPRACTIC REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 FOXFIRE RD
ELIZABETHTOWN KY
42701-9412
US

IV. Provider business mailing address

608 FOXFIRE RD
ELIZABETHTOWN KY
42701-9412
US

V. Phone/Fax

Practice location:
  • Phone: 270-307-9458
  • Fax:
Mailing address:
  • Phone: 270-307-9458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5374
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DERREK WESLEY STUDER
Title or Position: OWNER
Credential: D.C.
Phone: 270-307-9458