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General NPI Number Information
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NPI Number | 1306258488
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Entity Type | Organization
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Legal Business Name | BACK TALK CHIROPRACTIC PSC
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 1300 E NEW CIRCLE RD STE 160
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City | LEXINGTON
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State | KY
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Zip | 40505-4256
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Country | US
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Telephone | 859-309-0377
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Fax | 859-309-0381
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Provider Business Mailing Address
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Address Line | 1300 E NEW CIRCLE RD STE 160
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City | LEXINGTON
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State | KY
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Zip | 40505-4256
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Country | US
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Telephone | 859-309-0377
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Fax | 859-309-0381
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Authorized Official
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Title or Position | OWNER
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Name | DR. TAMERA L TOLSON
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Credential | DC, DACBSP
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Telephone | 859-309-0377
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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 | 5249
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License Number State | KY
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