Southside Chiropractic Psc | |
3198 Custer Dr Ste 100, Lexington, KY 40517-4000 | |
(859) 373-0800 | |
(859) 255-4104 |
Full Name | Southside Chiropractic Psc |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 3198 Custer Dr Ste 100, Lexington, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942380423 | NPI | - | NPPES |
000000209773 | Other | KY | BCBS |
85002269 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Darryl R Gregory |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1851471346 PECOS PAC ID: 0446337687 Enrollment ID: I20110107000479 |
Mailing Address | Practice Location Address |
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Southside Chiropractic Psc 3198 Custer Dr Ste 100, Lexington, KY 40517-4000 Ph: (859) 373-0800 | Southside Chiropractic Psc 3198 Custer Dr Ste 100, Lexington, KY 40517-4000 Ph: (859) 373-0800 |
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