Organization
SOUTHSIDE CHIROPRACTIC PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRYL R GREGORY DC (CHIROPRACTOR)
(859) 373-0800
Entity
Organization
Contact information
Practice address
3198 CUSTER DR STE 100, LEXINGTON, KY 40517-4000
(859) 373-0800
(859) 255-4104
Mailing address
3198 CUSTER DR STE 100, LEXINGTON, KY 40517-4000
(859) 373-0800
(859) 255-4104
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000209773
BCBS
KY
05
—
85002269
—
KY
Enumeration date
10/17/2006
Last updated
08/19/2014
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