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General NPI Number Information
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NPI Number | 1558314377
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Entity Type | Organization
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Legal Business Name | WEST LOUISVILLE CHIROPRACTIC INC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 2001 W BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40203-3595
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Country | US
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Telephone | 502-775-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 W BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40203-3595
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Country | US
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Telephone | 502-775-2273
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID MATTHEW EHRHARD
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Credential | D.C.
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Telephone | 502-775-2273
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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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