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General NPI Number Information
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NPI Number | 1174750996
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Entity Type | Organization
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Legal Business Name | UNION CHIROPRACTIC INJURY & REHABILITATION CENTER
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 5400 PRESTON HWY STE H
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City | LOUISVILLE
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State | KY
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Zip | 40213-2835
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Country | US
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Telephone | 502-964-1888
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Fax | 502-964-1878
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Provider Business Mailing Address
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Address Line | 5400 PRESTON HWY STE H
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City | LOUISVILLE
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State | KY
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Zip | 40213-2835
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Country | US
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Telephone | 502-964-1888
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Fax | 502-964-1878
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | HAGAR SARA GOLAN
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Credential | DC
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Telephone | 502-964-1888
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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 | 4996
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License Number State | KY
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