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General NPI Number Information
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NPI Number | 1730231309
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Entity Type | Organization
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Legal Business Name | AMERICAN CHIROPRACTIC-DOWNTOWN
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 418 E BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-1706
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Country | US
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Telephone | 502-681-6800
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Fax | 502-681-6868
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Provider Business Mailing Address
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Address Line | 418 E BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-1706
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Country | US
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Telephone | 502-681-6800
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Fax | 502-681-6868
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS V JACQUES
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Credential | DC
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Telephone | 502-681-6800
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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 | 4007
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License Number State | KY
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