Healthcare Provider Details

I. General information

NPI: 1134568546
Provider Name (Legal Business Name): LEXINGTON DISC & WELLNESS INSTITUTE FUNCTIONAL NUTRITION-CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3292 EAGLE VIEW LN SUITE 110
LEXINGTON KY
40509-2173
US

IV. Provider business mailing address

3292 EAGLE VIEW LN SUITE 110
LEXINGTON KY
40509-2173
US

V. Phone/Fax

Practice location:
  • Phone: 573-587-6578
  • Fax:
Mailing address:
  • Phone: 573-587-6578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number5266
License Number StateKY

VIII. Authorized Official

Name: DR. CHRIS JONES
Title or Position: OWNER
Credential: DC
Phone: 573-587-6578