Organization
SPINE STOP LAFAYETTE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WILSON (CREDENTIALING)
(636) 208-8163
Entity
Organization
Contact information
Practice address
501 HIGHWAY 52 BYP W, LAFAYETTE, TN 37083-2636
(270) 237-3304
Mailing address
352 OLD GALLATIN RD, SCOTTSVILLE, KY 42164-8666
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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