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General NPI Number Information
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NPI Number | 1295357531
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Entity Type | Organization
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Legal Business Name | UNBOUND TREATMENT, INC.
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Dates
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Enumeration Date | 05/09/2020
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 67 HARBOR DR
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City | JAMESTOWN
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State | KY
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Zip | 42629-8036
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Country | US
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Telephone | 502-352-2373
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 623
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City | JAMESTOWN
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State | KY
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Zip | 42629-0623
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Country | US
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Telephone | 720-810-6109
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVE KLIPP
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Credential |
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Telephone | 866-436-1284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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