Provider Demographics
NPI:1588824627
Name:KELLINGTON CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:KELLINGTON CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:CLARE
Authorized Official - Last Name:KELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-216-3334
Mailing Address - Street 1:9557B US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9301
Mailing Address - Country:US
Mailing Address - Phone:502-216-3334
Mailing Address - Fax:
Practice Address - Street 1:9557B US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9301
Practice Address - Country:US
Practice Address - Phone:502-216-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty