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General NPI Number Information
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NPI Number | 1487964318
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Entity Type | Organization
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Legal Business Name | ALL EASE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 1116 S MAIN ST SUITE 1
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City | MORGANTOWN
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State | KY
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Zip | 42261-9409
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Country | US
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Telephone | 270-526-6206
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Fax | 270-526-6296
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Provider Business Mailing Address
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Address Line | 1116 S MAIN ST SUITE 1
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City | MORGANTOWN
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State | KY
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Zip | 42261-9409
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Country | US
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Telephone | 270-526-6206
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Fax | 270-526-6296
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Authorized Official
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Title or Position | CHIROPRACTOR/SOLE OWNER
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Name | DR. VICKY LEASE
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Credential | DC
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Telephone | 270-526-6206
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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 | 5259
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License Number State | KY
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