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General NPI Number Information
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NPI Number | 1710171822
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC HEALTHCARE OF NORTHERN KENTUCKY
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 2865 CHANCELLOR DR SUITE 200
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3912
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Country | US
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Telephone | 859-491-8300
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Fax | 859-491-9649
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Provider Business Mailing Address
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Address Line | PO BOX 2082
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City | COVINGTON
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State | KY
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Zip | 41012-2082
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CYRIL PHILIP BENJAMIN
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Credential | DC
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Telephone | 859-491-8300
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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 | 4369
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License Number State | KY
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