Healthcare Provider Details

I. General information

NPI: 1245319037
Provider Name (Legal Business Name): RAYMOND RUSSELL UHLMANSIEK D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 MERCHANTS ST
FLORENCE KY
41042-1198
US

IV. Provider business mailing address

6068 TAYLOR DR APT. 156
BURLINGTON KY
41005-7981
US

V. Phone/Fax

Practice location:
  • Phone: 859-525-1695
  • Fax: 859-525-0169
Mailing address:
  • Phone: 502-435-4955
  • Fax: 859-525-0169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4988
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: