Organization · NPI-2

12th Street Chiropractic & Injury Rehabilitation, Psc

Chiropractor · Louisville, KY

NPI number1710294541
StatusActive
Last updated in NPPESSep 20, 2010

Details

NPI
1710294541
Entity type
Organization (NPI-2)
Legal business name
12th Street Chiropractic & Injury Rehabilitation, Psc
Organization subpart
No
Enumeration date
Aug 31, 2010
Last updated
Sep 20, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor––Yes

Practice location

1211 W Broadway Unit 101
Louisville, KY 40203-2082

Phone 502-587-7328 · Fax 502-587-7355

Mailing address

1211 W Broadway Unit 101
Louisville, KY 40203-2082

Phone 502-587-7328

Authorized official

Michael Clover
Chiropractor
5023861594

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