Healthcare Provider Details

I. General information

NPI: 1750487583
Provider Name (Legal Business Name): JOSEPH PAUL RALEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 MARKET PLACE DR
LOUISVILLE KY
40229-5450
US

IV. Provider business mailing address

254 MARKET PLACE DR
LOUISVILLE KY
40229-5450
US

V. Phone/Fax

Practice location:
  • Phone: 502-955-7246
  • Fax: 502-955-1508
Mailing address:
  • Phone: 502-955-7246
  • Fax: 502-955-1508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number250751
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number4384
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: