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General NPI Number Information
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NPI Number | 1427272202
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Entity Type | Organization
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Legal Business Name | REGENESIS CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 401 ADAMS ST
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City | DANVILLE
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State | KY
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Zip | 40422-1901
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Country | US
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Telephone | 859-236-0202
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Fax | 859-236-0102
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Provider Business Mailing Address
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Address Line | 401 ADAMS ST
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City | DANVILLE
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State | KY
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Zip | 40422-1901
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Country | US
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Telephone | 859-236-0202
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Fax | 859-236-0102
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH RAY PRICE
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Credential | D. C.
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Telephone | 859-236-0202
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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 | 5017
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License Number State | KY
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