Healthcare Provider Details

I. General information

NPI: 1851574651
Provider Name (Legal Business Name): CRAIG W PFEFFER CH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10131 TAYLORSVILLE RD
JEFFERSONTOWN KY
40299-3649
US

IV. Provider business mailing address

10131 TAYLORSVILLE RD
JEFFERSONTOWN KY
40299-3649
US

V. Phone/Fax

Practice location:
  • Phone: 502-267-6444
  • Fax: 502-267-6445
Mailing address:
  • Phone: 502-267-6444
  • Fax: 502-267-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3812
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: