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General NPI Number Information
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NPI Number | 1134850597
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Entity Type | Organization
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Legal Business Name | IMAC MEDICAL OF KENTUCKY PSC
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 2537 LARKIN RD
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City | LEXINGTON
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State | KY
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Zip | 40503-3201
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Country | US
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Telephone | 859-545-0043
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Fax | 502-264-9500
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Provider Business Mailing Address
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Address Line | 1605 WESTGATE CIR STE 100
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City | BRENTWOOD
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State | TN
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Zip | 37027-8396
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Country | US
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Telephone | 615-637-7333
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Fax | 615-637-7334
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | BAILEE BOYETT
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Credential |
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Telephone | 615-637-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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