Provider Demographics
NPI:1962444653
Name:LIFESTYLE RESUMPTION INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:LIFESTYLE RESUMPTION INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KLAUDE
Authorized Official - Middle Name:P
Authorized Official - Last Name:KOCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-344-6001
Mailing Address - Street 1:2182 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2902
Mailing Address - Country:US
Mailing Address - Phone:859-344-6001
Mailing Address - Fax:859-344-6005
Practice Address - Street 1:2182 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-2902
Practice Address - Country:US
Practice Address - Phone:859-344-6001
Practice Address - Fax:859-344-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty