Healthcare Provider Details

I. General information

NPI: 1104046028
Provider Name (Legal Business Name): BARNES FAMILY CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 03/08/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CANARY LN
WINCHESTER KY
40391-1645
US

IV. Provider business mailing address

29 CANARY LN
WINCHESTER KY
40391-1645
US

V. Phone/Fax

Practice location:
  • Phone: 606-831-4432
  • Fax: 859-744-7319
Mailing address:
  • Phone: 606-831-4432
  • Fax: 859-744-7319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3632-R
License Number StateKY

VIII. Authorized Official

Name: JEREMIAH HOLMES
Title or Position: OWNER
Credential: DC
Phone: 606-831-4432