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Organization

BLUEGRASS CHIROPRACTIC CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TERRY KEVYN MARMON DC (OWNER)
(502) 350-3700
Entity
Organization

Contact information

Practice address
606A BLOOMFIELD ROAD, BARDSTOWN, KY 40004
(502) 350-3700
Mailing address
606A BLOOMFIELD ROAD, BARDSTOWN, KY 40004
(502) 350-3700
(502) 350-3701

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4521
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1155747
PASSPORT
KY
05
85001931
KY
Enumeration date
11/20/2006
Last updated
02/29/2008
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