Healthcare Provider Details

I. General information

NPI: 1871878611
Provider Name (Legal Business Name): ABUNDANT ALTERNATIVES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 STABLE WAY
NICHOLASVILLE KY
40356-8046
US

IV. Provider business mailing address

233 STABLE WAY
NICHOLASVILLE KY
40356-8046
US

V. Phone/Fax

Practice location:
  • Phone: 859-948-9404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM L LEGG
Title or Position: ATTORNEY
Credential: ATTORNEY
Phone: 502-223-1030