Back 2 Life Chiropractic, PSC

Organization Active NPI Chiropractor · Georgetown, KY

NPI 1376725911 · NPPES record last updated Mar 10, 2011

Key facts

NPI
1376725911
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
4716 (KY)
Legal business name
BACK 2 LIFE CHIROPRACTIC, PSC
Practice address
104 Lawson Dr
Suite 107
Georgetown, KY 40324-8998
Phone
(502) 867-0089
Fax
(502) 867-0180
NPI assigned
Dec 5, 2007
Organization subpart
No

Authorized official

Name
Dr. Ryan M Bond, D. C.
Title
Chiropractor
Phone
(502) 867-0089

National Provider Directory

Locations

104 Lawson Dr
Ste 107
Georgetown, KY 40324
Phone (502) 867-0089

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 4716 KY Yes

Addresses

Primary practice location

104 Lawson Dr
Suite 107
Georgetown, KY 40324-8998

Mailing address

104 Lawson Dr
Suite 107
Georgetown, KY 40324-8998
Phone (502) 867-0089

Other identifiers

IdentifierTypeStateIssuer
000000227300OtherKYBLUECROSS BLUESHIELD
111N0000XOtherKYTAXONOMY
645717OtherKYUHC
8500227MedicaidKY
7197394OtherKYAETNA
1196909OtherKYCHA
7187OtherKYMEDICARE GROUP

Other names

  • Bond Chiropractic, PSC Former legal business name

Other providers in Georgetown, KY

All providers in Georgetown, KY · Chiropractor in Kentucky

Sources for this page

Verify at the official NPI Registry.