Provider Demographics
NPI:1073761961
Name:PREMIER CHIROPRACTIC OF NORTHERN KENTUCKY PLLC
Entity Type:Organization
Organization Name:PREMIER CHIROPRACTIC OF NORTHERN KENTUCKY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEARHART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-283-5999
Mailing Address - Street 1:7541 MALL RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1401
Mailing Address - Country:US
Mailing Address - Phone:859-283-5999
Mailing Address - Fax:859-283-5103
Practice Address - Street 1:7541 MALL RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1401
Practice Address - Country:US
Practice Address - Phone:859-283-5999
Practice Address - Fax:859-283-5103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty