Provider Demographics
NPI:1730483967
Name:KENTUCKY OSTEO RELIEF INSTITUTE
Entity Type:Organization
Organization Name:KENTUCKY OSTEO RELIEF INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCATENA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-223-0488
Mailing Address - Street 1:1019 MAJESTIC DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1496
Mailing Address - Country:US
Mailing Address - Phone:859-223-0488
Mailing Address - Fax:859-223-0494
Practice Address - Street 1:1019 MAJESTIC DR
Practice Address - Street 2:SUITE 160
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1496
Practice Address - Country:US
Practice Address - Phone:859-223-0488
Practice Address - Fax:859-223-0494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4994204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty