| |
3707 Chamberlain Ln, Suite 101, Louisville, KY 40241-2001 | |
(502) 426-9200 | |
(502) 426-9259 |
Full Name | |
---|---|
Type | Facility |
Speciality | General Practice |
Location | 3707 Chamberlain Ln, Louisville, Kentucky |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811152713 | NPI | - | NPPES |
64330095 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 4390 (Kentucky) | Secondary |
208D00000X | General Practice | 33009 (Kentucky) | Primary |
Mailing Address | Practice Location Address |
---|---|
3707 Chamberlain Ln, Suite 101, Louisville, KY 40241-2001 Ph: (502) 426-9200 | 3707 Chamberlain Ln, Suite 101, Louisville, KY 40241-2001 Ph: (502) 426-9200 |