Provider Demographics
NPI:1275240517
Name:NBK CENTER
Entity Type:Organization
Organization Name:NBK CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-368-1376
Mailing Address - Street 1:7560 US HWY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1908
Mailing Address - Country:US
Mailing Address - Phone:513-368-1376
Mailing Address - Fax:859-283-0097
Practice Address - Street 1:2030 NORTHSIDE DR UNIT C
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-7196
Practice Address - Country:US
Practice Address - Phone:859-372-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty