Provider Demographics
NPI:1962753665
Name:BOISVERT ENTERPRISES LLC
Entity type:Organization
Organization Name:BOISVERT ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:R
Authorized Official - Last Name:BOISVERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-354-7041
Mailing Address - Street 1:2459 NICHOLASVILLE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3181
Mailing Address - Country:US
Mailing Address - Phone:859-278-8000
Mailing Address - Fax:859-523-0474
Practice Address - Street 1:2459 NICHOLASVILLE RD STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3181
Practice Address - Country:US
Practice Address - Phone:859-278-8000
Practice Address - Fax:859-523-0474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5052111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty