Provider Demographics
NPI:1013395318
Name:DR DON INC
Entity Type:Organization
Organization Name:DR DON INC
Other - Org Name:INTEGRATIVE CHIROPRACTIC AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-618-3060
Mailing Address - Street 1:4602 SOUTHERN PKWY
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-1429
Mailing Address - Country:US
Mailing Address - Phone:502-618-3060
Mailing Address - Fax:502-618-3060
Practice Address - Street 1:4602 SOUTHERN PKWY
Practice Address - Street 2:SUITE 2A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1429
Practice Address - Country:US
Practice Address - Phone:502-618-3060
Practice Address - Fax:502-618-3060
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR DON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty