| Boardman Family Chiropractic Psc | |
|
837 Eastern Byp Ste A Richmond KY 40475-3326 | |
| (606) 831-4432 | |
| (859) 623-2037 |
| Full Name | Boardman Family Chiropractic Psc |
|---|---|
| Speciality | Chiropractor |
| Location | 837 Eastern Byp Ste A, Richmond, Kentucky |
| Authorized Official Name and Position | Jeremiah Holmes (DC OWNER) |
| Authorized Official Contact | 6068314432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boardman Family Chiropractic Psc 837 Eastern Byp Ste A Richmond KY 40475-3326 Ph: (606) 831-4432 | Boardman Family Chiropractic Psc 837 Eastern Byp Ste A Richmond KY 40475-3326 Ph: (606) 831-4432 |
| NPI Number | 1679619829 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 03/07/2024 |
| Medicare PECOS PAC ID | 8729325998 |
|---|---|
| Medicare Enrollment ID | O20190125000597 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679619829 | NPI | - | NPPES |
| 000000088188 | Other | KY | CHA |
| 7646218 | Other | KY | AETNA |
| 000000192918 | Other | KY | ANTHEM |
| 7100588260 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Jeremiah J Holmes |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689771081 PECOS PAC ID: 8224923123 Enrollment ID: I20040219000226 |
| Provider Name | Kathleen Rizenbergs |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366959462 PECOS PAC ID: 3779846340 Enrollment ID: I20180412000994 |
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