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General NPI Number Information
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NPI Number | 1154977890
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Entity Type | Organization
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Legal Business Name | DANVILLE FAMILY CHIROPRACTIC 2019 PLLC
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 434 W WALNUT ST
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City | DANVILLE
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State | KY
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Zip | 40422-1846
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Country | US
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Telephone | 859-239-0022
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Fax | 859-239-0044
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Provider Business Mailing Address
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Address Line | 434 W WALNUT ST
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City | DANVILLE
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State | KY
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Zip | 40422-1846
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Country | US
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Telephone | 859-239-0022
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Fax | 859-239-0044
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | TOSHA MCCORMACK
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Credential |
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Telephone | 859-408-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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