Individual
DR. JAIME GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
10110 DIXIE HWY, LOUISVILLE, KY 40272-3948
(502) 937-7995
(503) 937-5560
Mailing address
10110 DIXIE HWY, LOUISVILLE, KY 40272-3948
(502) 937-7995
(503) 937-5560
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5135
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100072710
—
KY
01
—
K030550
MEDICARE PTAN
KY
Enumeration date
01/27/2006
Last updated
11/04/2011
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