| Spine Center Inc | |
|
8707 Old Bardstown Rd, Louisville, KY 40291-4435 | |
| (502) 231-4003 | |
| (502) 384-0374 |
| Full Name | Spine Center Inc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 8707 Old Bardstown Rd, Louisville, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053531665 | NPI | - | NPPES |
| 7100148500 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4532 (Kentucky) | Primary |
| Provider Name | Todd Mcgee Hostutler |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1609980457 PECOS PAC ID: 1658267265 Enrollment ID: I20040223000247 |
| Provider Name | Justin Gregory Brown |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1770171258 PECOS PAC ID: 6305250010 Enrollment ID: I20210120002249 |
| Provider Name | Rebekah Ann Dunn |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134717721 PECOS PAC ID: 7719391531 Enrollment ID: I20210205000917 |
| Mailing Address | Practice Location Address |
|---|---|
| Spine Center Inc 8707 Old Bardstown Rd, Louisville, KY 40291-4435 Ph: (502) 231-4003 | Spine Center Inc 8707 Old Bardstown Rd, Louisville, KY 40291-4435 Ph: (502) 231-4003 |
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