Provider Demographics
NPI:1457773152
Name:LCT CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:LCT CHIROPRACTIC PLLC
Other - Org Name:GEORGETOWN FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-868-0097
Mailing Address - Street 1:100 EASTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9797
Mailing Address - Country:US
Mailing Address - Phone:502-868-0097
Mailing Address - Fax:502-868-7499
Practice Address - Street 1:100 EASTSIDE DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9797
Practice Address - Country:US
Practice Address - Phone:502-868-0097
Practice Address - Fax:502-868-7499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100426970Medicaid
KYK093842Medicare PIN