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Organization

RUNYON SPECIFIC CHIROPRACTIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON WAYNE RUNYON D.C. (CHIROPRACTOR)
(606) 833-9355
Entity
Organization

Contact information

Practice address
1448 DIEDERICH BLVD, RUSSELL, KY 41169-1719
(606) 833-9355
(606) 833-1895
Mailing address
PO BOX 741, ASHLAND, KY 41105-0741
(606) 833-9355
(606) 833-1895

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4816
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000336562
BLUE CROSS BLUE SHIELD
KY
05
2634242
OH
05
85003416
KY
Enumeration date
11/01/2007
Last updated
11/07/2008
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