Healthcare Provider Details

I. General information

NPI: 1508044496
Provider Name (Legal Business Name): EHN FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1853 MONMOUTH ST
NEWPORT KY
41071-2637
US

IV. Provider business mailing address

1853 MONMOUTH ST
NEWPORT KY
41071-2637
US

V. Phone/Fax

Practice location:
  • Phone: 859-292-0123
  • Fax: 859-292-0131
Mailing address:
  • Phone: 859-292-0123
  • Fax: 859-292-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4647
License Number StateKY

VIII. Authorized Official

Name: DR. TIMOTHY EHN
Title or Position: DIRECTOR
Credential: D.C
Phone: 859-292-0123