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General NPI Number Information
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NPI Number | 1972057388
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Entity Type | Organization
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Legal Business Name | HAMBURG CHIROPRACTIC & FUNCTIONAL NUTRITION
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 1890 STAR SHOOT PKWY SUITE 185
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City | LEXINGTON
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State | KY
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Zip | 40509-4566
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Country | US
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Telephone | 859-263-2774
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Fax | 859-263-2787
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Provider Business Mailing Address
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Address Line | 811 LEESBURG PIKE
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City | GEORGETOWN
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State | KY
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Zip | 40324-9766
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Country | US
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Telephone | 859-263-2774
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Fax | 859-263-2787
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA ANN LEVERETTE
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Credential | DC
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Telephone | 859-263-2774
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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 |
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License Number State | KY
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