Provider Demographics
NPI:1912198714
Name:PUNTNEY, IAN MARCUS (DC)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:MARCUS
Last Name:PUNTNEY
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 1:617 CECIL WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2101
Mailing Address - Country:US
Mailing Address - Phone:859-537-0667
Mailing Address - Fax:
Practice Address - Street 1:535 WELLINGTON WAY
Practice Address - Street 2:SUITE 270
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1385
Practice Address - Country:US
Practice Address - Phone:859-309-1996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010948111N00000X
KY5087111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor