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General NPI Number Information
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NPI Number | 1982746913
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Entity Type | Organization
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Legal Business Name | BLUEGRASS FAMILY CHIROPRACTIC, PSC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 1011 PARIS ROAD #341
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City | MAYFIELD
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State | KY
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Zip | 42066
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Country | US
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Telephone | 270-251-0907
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Fax | 270-251-0908
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Provider Business Mailing Address
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Address Line | 1011 PARIS ROAD #341
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City | MAYFIELD
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State | KY
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Zip | 42066
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Country | US
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Telephone | 270-251-0907
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Fax | 270-251-0908
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHAD STEVEN YOUNG
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Credential | DC
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Telephone | 270-251-0907
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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 | 4764
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License Number State | KY
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