Provider Demographics
NPI:1578649620
Name:NEVILLE, DAVID ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:NEVILLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 DUDLEY PIKE
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017
Mailing Address - Country:US
Mailing Address - Phone:859-426-1100
Mailing Address - Fax:859-426-0809
Practice Address - Street 1:998 DUDLEY PIKE
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-426-1100
Practice Address - Fax:859-426-0809
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY248917111N00000X
KY50566100111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor