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General NPI Number Information
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NPI Number | 1497387864
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Entity Type | Organization
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Legal Business Name | CENTRAL CITY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 1731 W EVERLY BROTHERS BLVD
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City | CENTRAL CITY
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State | KY
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Zip | 42330-1833
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Country | US
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Telephone | 270-754-1335
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Fax | 270-757-9478
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Provider Business Mailing Address
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Address Line | 1731 W EVERLY BROTHERS BLVD
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City | CENTRAL CITY
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State | KY
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Zip | 42330-1833
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Country | US
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Telephone | 270-754-1335
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Fax | 270-757-9478
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. GERALD WAYNE JOINES II
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Credential | DC
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Telephone | 270-754-1335
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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 |
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License Number State |
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