Lagrange Chiropractic PSC
Organization Active NPI Chiropractor · Lagrange, KY
NPI 1477679587 · NPPES record last updated Aug 6, 2008
Key facts
- NPI
- 1477679587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4315 (KY)
- Legal business name
- LAGRANGE CHIROPRACTIC PSC
- Practice address
- 301 S 1St St
Lagrange, KY 40031 - Phone
- (502) 222-0000
- Fax
- (502) 222-3488
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Lido Lee Petrucci, DC
- Title
- Doctor
- Phone
- (502) 222-0000
Practitioners 1
-
Lido L Petrucci, DC
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 4315 | KY | Yes |
Addresses
Primary practice location
301 S 1St St
Lagrange, KY 40031
Mailing address
301 S 1St St
Lagrange, KY 40031
Phone (502) 222-0000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2438073000 | Other | KY | PASSPORT ADVANTAGE |
| 350048657 | Other | KY | RAILROAD MEDICARE |
| 0974279 | Other | KY | AETNA |
| 1140369 | Other | KY | PASSPORT |
| 9943660003 | Other | KY | CIGNA |
| 85036697 | Medicaid | KY |
Other names
- LaGrange Chiropractic
Other providers in Lagrange, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.