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General NPI Number Information
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NPI Number | 1205202645
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Entity Type | Organization
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Legal Business Name | EAST KENTUCKY CHIROPRACTIC
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 148 TAYLOR RIDGE RD
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City | HAZARD
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State | KY
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Zip | 41701-6659
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Country | US
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Telephone | 606-487-8255
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Fax | 606-487-8433
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Provider Business Mailing Address
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Address Line | 148 TAYLOR RIDGE RD
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City | HAZARD
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State | KY
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Zip | 41701-6659
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Country | US
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Telephone | 606-487-8255
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Fax | 606-487-8433
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DR. AMANDA LAFERTY
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Credential | DC
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Telephone | 606-487-8255
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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 | 5183
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4560
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License Number State | KY
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