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General NPI Number Information
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NPI Number | 1679619829
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Entity Type | Organization
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Legal Business Name | BOARDMAN FAMILY CHIROPRACTIC PSC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 837 EASTERN BYP STE A
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City | RICHMOND
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State | KY
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Zip | 40475-3326
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Country | US
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Telephone | 606-831-4432
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Fax | 859-623-2037
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Provider Business Mailing Address
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Address Line | 837 EASTERN BYP STE A
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City | RICHMOND
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State | KY
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Zip | 40475-3326
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Country | US
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Telephone | 606-831-4432
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Fax | 859-623-2037
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Authorized Official
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Title or Position | DC OWNER
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Name | JEREMIAH HOLMES
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Credential |
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Telephone | 606-831-4432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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