Organization
MAGNA CHIRO MED, LLC
Active
Other names
Magna Chiropractic, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLI BROWN (OFFICE MANAGER)
(270) 746-9400
Entity
Organization
Contact information
Practice address
2424 AIRWAY DR, SUITE B, BOWLING GREEN, KY 42103-7125
(270) 746-9400
(270) 746-0240
Mailing address
2424 AIRWAY DR, SUITE B, BOWLING GREEN, KY 42103-7125
(270) 746-9400
(270) 746-0240
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4950
KY
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285629154
NPI
KY
01
—
1396723755
NPI
KY
01
—
1821143009
CLINIC NPI
KY
05
—
85003317
—
KY
05
—
85003762
—
KY
Enumeration date
01/25/2007
Last updated
02/17/2014
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