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General NPI Number Information
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NPI Number | 1245747674
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Entity Type | Organization
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Legal Business Name | PHAUP CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 1015 COLLEGE DR
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City | MADISONVILLE
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State | KY
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Zip | 42431-9189
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Country | US
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Telephone | 270-452-2187
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 COLLEGE DR
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City | MADISONVILLE
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State | KY
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Zip | 42431-9189
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Country | US
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Telephone | 270-452-2187
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMBER LONG
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Credential |
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Telephone | 270-452-2187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5477
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License Number State | KY
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