Healthcare Provider Details

I. General information

NPI: 1629939426
Provider Name (Legal Business Name): BERNADETTE BODHI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 OLD ROSEBUD RD STE 230
LEXINGTON KY
40509-8003
US

IV. Provider business mailing address

812 HENRY CLAY BLVD
LEXINGTON KY
40505-4058
US

V. Phone/Fax

Practice location:
  • Phone: 859-263-8833
  • Fax: 859-447-8135
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number249672
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: