MEDICARE: PREBLE CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3668-R	KY

General Provider Information

NPI Number	:	1922263904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREBLE CHIROPRACTIC

Provider Business Mailing Address
First Line	:	102 W MADISON ST
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-1428
Country	:	US
Telephone Number	:	502-222-7611
Fax Number	:	502-222-2321

Provider Business Practice Location Address
First Line	:	102 W MADISON ST
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-1428
Country	:	US
Telephone Number	:	502-222-7611
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. LAURENCE DANIEL PREBLE
Credential	:	D.C.
Telephone Number	:	502-222-7611

Provider Enumeration Date	:	07/19/2008
Last Update Date	:	01/29/2014

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Directions to “PREBLE CHIROPRACTIC ” Practice Location

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