Provider Demographics
NPI:1467784827
Name:LEXINGTON FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:LEXINGTON FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-264-1140
Mailing Address - Street 1:131 PROSPEROUS PL
Mailing Address - Street 2:SUITE 15
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1853
Mailing Address - Country:US
Mailing Address - Phone:859-264-1140
Mailing Address - Fax:859-245-1190
Practice Address - Street 1:131 PROSPEROUS PL
Practice Address - Street 2:SUITE 15
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1853
Practice Address - Country:US
Practice Address - Phone:859-264-1140
Practice Address - Fax:859-245-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3416485OtherAETNA HMO
KY664708OtherUNITED/ACN
KY85002970Medicaid
KY770498OtherAETNA
KY7764195OtherCIGNA
KY000000352212OtherANTHEM BCBS