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General NPI Number Information
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NPI Number | 1891107520
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC HEALTH CENTER, PSC
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 3631 DECOURSEY AVE
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City | COVINGTON
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State | KY
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Zip | 41015-1436
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Country | US
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Telephone | 859-431-2273
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Fax | 859-431-6937
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Provider Business Mailing Address
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Address Line | 3631 DECOURSEY AVE
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City | COVINGTON
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State | KY
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Zip | 41015-1436
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Country | US
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Telephone | 859-431-2273
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Fax | 859-431-6937
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ROBERT MARK REEVES
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Credential | D.C.
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Telephone | 859-431-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 4162
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License Number State | KY
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