Healthcare Provider Details

I. General information

NPI: 1023948536
Provider Name (Legal Business Name): KENTUCKY GONSTEAD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 WILLIAM THOMASON BYU
LEITCHFIELD KY
42754-1420
US

IV. Provider business mailing address

415 CARDINAL DR
ELIZABETHTOWN KY
42701-2769
US

V. Phone/Fax

Practice location:
  • Phone: 803-493-8873
  • Fax: 256-646-1290
Mailing address:
  • Phone: 803-493-8873
  • Fax: 256-646-1290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARGARET PACE
Title or Position: OWNER
Credential: DC
Phone: 803-493-8873