Provider Demographics
NPI:1417386269
Name:LEXINGTON DISC & WELLNESS MEDICAL-NUTRITION-AUBREY CHIROPRACTIC
Entity type:Organization
Organization Name:LEXINGTON DISC & WELLNESS MEDICAL-NUTRITION-AUBREY CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-671-9006
Mailing Address - Street 1:2408 SIR BARTON WAY
Mailing Address - Street 2:SUITE 275
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8300
Mailing Address - Country:US
Mailing Address - Phone:502-671-9006
Mailing Address - Fax:
Practice Address - Street 1:2408 SIR BARTON WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8300
Practice Address - Country:US
Practice Address - Phone:502-671-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4999111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty