Provider Demographics
NPI:1467971879
Name:ESSENTIAL CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ESSENTIAL CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-314-4320
Mailing Address - Street 1:171 W LOWRY LN STE 164
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3006
Mailing Address - Country:US
Mailing Address - Phone:859-277-5077
Mailing Address - Fax:
Practice Address - Street 1:171 W LOWRY LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3018
Practice Address - Country:US
Practice Address - Phone:859-277-5077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty