Healthcare Provider Details

I. General information

NPI: 1912214651
Provider Name (Legal Business Name): CHIROPRACTIC HEALTH SOLUTIONS OF MCKEE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 09/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 HWY 290
MCKEE KY
40447
US

IV. Provider business mailing address

PO BOX 425
MC KEE KY
40447-0425
US

V. Phone/Fax

Practice location:
  • Phone: 606-287-2225
  • Fax:
Mailing address:
  • Phone: 606-287-2225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4733
License Number StateKY

VIII. Authorized Official

Name: KRISTA R DODSON
Title or Position: ADMINISTRATIVE ASSISTANT TO THE DR
Credential:
Phone: 859-985-0606