Organization
LYNN-GAIL PLLC
Active
Other names
Shivley Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN WIETFELDT DC (PRESIDENT)
(502) 647-4600
Entity
Organization
Contact information
Practice address
4123 TAYLOR BLVD, LOUISVILLE, KY 40215-2341
(502) 363-7172
(502) 363-7174
Mailing address
60 STONECREST CT, SUITE 140, SHELBYVILLE, KY 40065-8155
(502) 647-4600
(502) 647-4607
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4867
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4867
STATE LICENSE NUMBER
KY
Enumeration date
06/07/2007
Last updated
09/15/2009
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