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Organization
IMAC MEDICAL OF KENTUCKY PSC
Active
Organization
IMAC MEDICAL OF KENTUCKY PSC
Active
Other names
IMAC Medical of Kentucky PSC
Organization subpart
No
Provider details
NPI number
Authorized official
BAILEE BOYETT (CREDENTIALING SPECIALIST)
(615) 678-0024
Entity
Organization
Contact information
Practice address
2537 LARKIN RD, LEXINGTON, KY 40503-3201
(859) 545-0043
Mailing address
1605 WESTGATE CIR STE 100, BRENTWOOD, TN 37027-8396
(615) 678-0024
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
03/02/2022
Last updated
04/11/2022
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