Provider Demographics
NPI:1225667652
Name:REGENCY CHIROPRACTIC
Entity Type:Organization
Organization Name:REGENCY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-219-1014
Mailing Address - Street 1:3165 BEAUMONT CENTRE CIR STE 130
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1966
Mailing Address - Country:US
Mailing Address - Phone:859-219-1014
Mailing Address - Fax:859-219-1017
Practice Address - Street 1:171 W LOWRY LN STE 164
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3006
Practice Address - Country:US
Practice Address - Phone:859-278-0083
Practice Address - Fax:859-278-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty