Organization
ALLIANCE CHIROPRACTIC OF SE, LLC
Active
Other names
Natural Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSEN R. KHANI D.C. (MANAGING DIRECTOR)
(502) 367-2112
Entity
Organization
Contact information
Practice address
10701 W MANSLICK RD, FAIRDALE, KY 40118-9581
(502) 367-2112
(502) 367-7799
Mailing address
10701 W MANSLICK ROAD, FAIRDALE, KY 40118
(502) 367-2112
(502) 367-7799
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4056
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108878
ANTHEM
KY
01
—
1150522
PASSPORT MEDICAID
KY
01
—
350053484
RAILROAD MEDICARE
KY
05
—
85001568
—
KY
Enumeration date
12/29/2006
Last updated
03/11/2014
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