Healthcare Provider Details

I. General information

NPI: 1477926467
Provider Name (Legal Business Name): YEARLING CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LEESTOWN RD SUITE 304
LEXINGTON KY
40511-2044
US

IV. Provider business mailing address

1500 LEESTOWN RD SUITE 304
LEXINGTON KY
40511-2044
US

V. Phone/Fax

Practice location:
  • Phone: 859-523-3920
  • Fax:
Mailing address:
  • Phone: 859-523-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BRIAN D ANDERSON
Title or Position: OWNER
Credential: DC
Phone: 859-523-3920