Healthcare Provider Details

I. General information

NPI: 1629947155
Provider Name (Legal Business Name): ESTEVE PROFESSIONAL REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 WINCHESTER RD STE 125
LEXINGTON KY
40505-4042
US

IV. Provider business mailing address

1132 WINCHESTER RD STE 125
LEXINGTON KY
40505-4042
US

V. Phone/Fax

Practice location:
  • Phone: 859-254-0059
  • Fax:
Mailing address:
  • Phone: 859-254-0059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRISTIAN D ESTEVE
Title or Position: OWNER
Credential: DC
Phone: 859-254-0059