| NPI | 1992221741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB GLENN HEABERLIN CEO 859-893-8184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2011003626) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KY 5500) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2025-02-04 |