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General NPI Number Information
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NPI Number | 1598789091
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Entity Type | Organization
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Legal Business Name | ASHLAND CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 613 13TH ST
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City | ASHLAND
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State | KY
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Zip | 41101-2617
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Country | US
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Telephone | 606-329-8080
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Fax | 606-325-8550
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Provider Business Mailing Address
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Address Line | 613 13TH ST
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City | ASHLAND
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State | KY
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Zip | 41101-2617
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Country | US
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Telephone | 606-329-8080
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Fax | 606-325-8550
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | JUSTIN F SWANN
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Credential | DC
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Telephone | 606-329-8080
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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 | 4525
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License Number State | KY
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