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General NPI Number Information
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NPI Number | 1689829012
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Entity Type | Organization
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Legal Business Name | OBRIEN CHIROPRACTIC PSC
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 775 E TOM T HALL BLVD
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City | OLIVE HILL
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State | KY
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Zip | 41164-7040
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Country | US
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Telephone | 606-286-1000
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Fax | 606-286-0860
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Provider Business Mailing Address
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Address Line | 775 E TOM T HALL BLVD
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City | OLIVE HILL
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State | KY
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Zip | 41164-7040
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Country | US
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Telephone | 606-286-1000
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Fax | 606-286-0860
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY W OBRIEN
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Credential | DC
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Telephone | 606-286-1000
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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 | 5031
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License Number State | KY
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