Healthcare Provider Details

I. General information

NPI: 1417386269
Provider Name (Legal Business Name): LEXINGTON DISC & WELLNESS MEDICAL-NUTRITION-AUBREY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 11/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 SIR BARTON WAY
LEXINGTON KY
40509-8300
US

IV. Provider business mailing address

2408 SIR BARTON WAY SUITE 275
LEXINGTON KY
40509-8300
US

V. Phone/Fax

Practice location:
  • Phone: 502-671-9006
  • Fax:
Mailing address:
  • Phone: 502-671-9006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number4999
License Number StateKY

VIII. Authorized Official

Name: DR. LARRY ANTHONY SEARS
Title or Position: OWNER
Credential:
Phone: 502-671-9006