Individual
KEVIN M STATOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2210 MEADOW DR, STE 5, LOUISVILLE, KY 40218-1374
(502) 822-1668
Mailing address
2210 MEADOW DR, STE 5, LOUISVILLE, KY 40218-1374
(502) 822-1668
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5165
KY
Other
Enumeration date
01/29/2007
Last updated
04/03/2015
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