Organization
12TH STREET CHIROPRACTIC & INJURY REHABILITATION, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CLOVER (CHIROPRACTOR)
(502) 386-1594
Entity
Organization
Contact information
Practice address
1211 W BROADWAY UNIT 101, LOUISVILLE, KY 40203-2082
(502) 587-7328
(502) 587-7355
Mailing address
1211 W BROADWAY UNIT 101, LOUISVILLE, KY 40203-2082
(502) 587-7328
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
08/31/2010
Last updated
09/20/2010
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