Individual
BEAU JORDAN VAN WECHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8761 US HIGHWAY 42 STE C, UNION, KY 41091-9316
(859) 647-7780
Mailing address
8761 US HIGHWAY 42 STE C, UNION, KY 41091-9316
(859) 647-7780
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
107840
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107840
STATE LICENSE
IA
Enumeration date
03/15/2021
Last updated
03/24/2023
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