Healthcare Provider Details

I. General information

NPI: 1043146467
Provider Name (Legal Business Name): MADISON BRYANT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1183 BROCK MCVEY DR STE D
LEXINGTON KY
40509-4166
US

IV. Provider business mailing address

1183 BROCK MCVEY DR STE D
LEXINGTON KY
40509-4166
US

V. Phone/Fax

Practice location:
  • Phone: 859-213-0651
  • Fax:
Mailing address:
  • Phone: 859-559-7673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number309253
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: