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Individual

DR. WILLIAM BLAKE MAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
820 CHUCK GRAY CT., OWENSBORO, KY 42303-7362
(270) 685-5100
(270) 683-3100
Mailing address
820 CHUCK GRAY CT., OWENSBORO, KY 42303-7362
(270) 685-5100
(270) 683-3100

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5158
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100197940
KY
01
K037050
MEDICARE
KY
Enumeration date
07/19/2011
Last updated
05/09/2016
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