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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