Provider Demographics
NPI:1275323057
Name:BLEVINS, COURTNEY PAIGE (DC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:PAIGE
Last Name:BLEVINS
Suffix:
Gender:
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:PO BOX 538
Mailing Address - Street 2:
Mailing Address - City:ELKHORN CITY
Mailing Address - State:KY
Mailing Address - Zip Code:41522-0538
Mailing Address - Country:US
Mailing Address - Phone:864-909-6557
Mailing Address - Fax:
Practice Address - Street 1:108 PASADENA DR STE 110
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2966
Practice Address - Country:US
Practice Address - Phone:859-303-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY280931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor