Organization Name: | O'DELL CHIROPRACTIC CENTER, LLC |
NPI Number: | 1003202185 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID M O'DELL (OWNER) |
Mailing Address: | 2007 Merchant Dr Richmond |
State: | KY US |
Postal Code: | 404758167 |
Phone Number: | 8595751222 |
Fax Number: | 8595751225 |
NPI Enumeration Date: | 04/15/2015 |
NPI Last Update Date: | 04/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 5284 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |