Provider Demographics
NPI:1154829521
Name:FARNSLEY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:FARNSLEY CHIROPRACTIC, PLLC
Other - Org Name:FARNSLEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-290-2003
Mailing Address - Street 1:3500 DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216
Mailing Address - Country:US
Mailing Address - Phone:502-290-2003
Mailing Address - Fax:
Practice Address - Street 1:3500 DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216
Practice Address - Country:US
Practice Address - Phone:502-290-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty